Pharmacy Prior Authorization Specialist: Drive Coverage

UHS; Reno (NV); On-site; USD 55,000 - 74,000; Full time

Benefits offered by this job

Loan Forgiveness

Excellent Medical, Dental, Vision and

401(K) with company match

Job summary

Prominence Health Plan seeks a Pharmacy Authorization Specialist (Pharmacy Technician) to coordinate prior authorization reviews for injectable drugs between members, providers, and the health plan. You will load PA requests with diagnoses and billing codes, verify dose and frequency, and perform provider outreach to obtain documentation for coverage determinations.

This role supports an efficient pharmacy workflow and aims to improve satisfaction for members and providers with the prior

Qualifications

• High School diploma or equivalent.
• Current and valid state licensure as a pharmacy technician is required.
• 3+ years in hospital or retail pharmacy is preferred.
• Ability to communicate effectively in English, both verbally and in writing.
• Knowledge of medical terminology.

Responsibilities

• Coordinate prior authorization reviews for injectable drugs between Prominence Health Plan, members and providers.
• Load prior authorizations with diagnoses and billing codes, verify dose and frequency.
• Perform provider outreach to obtain documentation for coverage determinations.
• Improve internal workflow of the pharmacy team and enhance member/provider satisfaction.

Skills

Communication

Medical terminology

Customer service

Microsoft Office

English proficiency

Education

High School diploma or equivalent

Tools

Microsoft Office

Job description

Prominence Health Plan seeks a Pharmacy Authorization Specialist (Pharmacy Technician) to coordinate prior authorization reviews for injectable drugs between members, providers, and the health plan. You will load PA requests with diagnoses and billing codes, verify dose and frequency, and perform provider outreach to obtain documentation for coverage determinations.

This role supports an efficient pharmacy workflow and aims to improve satisfaction for members and providers with the prior