Pharmacy Prior Authorization Specialist

CVS Health; Phoenix (AZ); Remote; USD 25,000 - 49,000; Full time

Benefits offered by this job

Medical benefits

Dental benefits

Vision benefits

Paid time off

Retirement savings options

Wellness programs

Job summary

CVS Health is hiring for a Pharmacy Prior Authorization Technician to support PA reviews and approvals. You will handle inquiries from providers and internal partners, document decisions, and ensure NCQA standards are met while maintaining accuracy and timeliness.

The role requires national pharmacy technician certification and state licensure, 1–5+ years of PA experience, and strong multitasking and organization skills. Benefits and a stable, full-time schedule accompany this position.

Qualifications

• National Pharmacy Technician certification and Arizona or applicable state license in good standing.
• 1–5+ years of Pharmacy Prior Authorization processing experience.
• Ability to multi-task and prioritize work.
• Ability to adjust based on business or department needs.
• Good organization skills.

Responsibilities

• Process prior authorization requests by phone, fax, or electronic, using clinical guidelines.
• Complete prior authorization approvals and denials with timely documentation.
• Review denial language to ensure NCQA requirements are met.
• Follow PA workflow, policies, and procedures during the workday.
• Answer high volume PA inquiries from provider offices, pharmacies, and internal partners.
• Maintain productivity, quality and timeliness of work.
• Participate in training and continuing education.
• Attend team/departmental meetings and maintain excellent attendance.
• Demonstrate proficiency in drug names, diagnosis pronunciation, and clinical information.
• Possess strong written and verbal communication skills.

Skills

Multitasking

Prioritization

Communication

Organization

Education

High School Diploma or GED

Tools

AS400

MS Office

Electronic health records software

Job description

CVS Health is hiring for a Pharmacy Prior Authorization Technician to support PA reviews and approvals. You will handle inquiries from providers and internal partners, document decisions, and ensure NCQA standards are met while maintaining accuracy and timeliness.

The role requires national pharmacy technician certification and state licensure, 1–5+ years of PA experience, and strong multitasking and organization skills. Benefits and a stable, full-time schedule accompany this position.