Pharmacy Prior Authorization Technician

MedStar Health; Waldorf (MD); On-site; USD 27,000 - 47,000; Full time

Job summary

MedStar Health is seeking a Pharmacy Technician to support prior authorization processes under the direction of health plan pharmacists. You will gather information, communicate with patients and providers, and assist with regulatory reporting and quality initiatives.

The role requires 1–2 years of outpatient pharmacy experience, an LPT license upon hire, and a HS diploma or GED. On-site role in Waldorf, MD with competitive hourly pay.

Qualifications

• 1-2 years experience as a pharmacy technician in an outpatient dispensing pharmacy required.
• Experience supporting quality improvement goals with focus on HEDIS preferred.
• Previous experience with prior authorization review processes preferred.
• Health Literacy Training preferred.
• Health Equity Training preferred.

Responsibilities

• Facilitates the accurate and timely processing of medication prior authorization requests.
• Communicates with patients, providers, and dispensing pharmacies to support medication-related requests and other departmental initiatives.
• Collects all pertinent information for Medical Reviewers to complete medication prior authorization clinical evaluation.
• Pharmacy Operations activities including reviewing and finalizing PBM reports; supports staff dashboards.
• Supports medication-related initiatives that align with strategic priorities under Pharmacist oversight.
• Completes required regulatory reports that the health plan submits to regulators.
• Performs administrative tasks as requested by departmental leadership.
• Participates in development and expansion of pharmacy initiatives; develops SOPs and workflows.
• Supports case management and precertification team to facilitate overrides.
• Creates a pharmacy resource manual for the precertification team.
• Assists with website content management.
• Provides polypharmacy follow-up support for patients.
• On-call coverage for pharmacy prior authorization requests outside normal hours on a rotating basis.
• Acts as Subject Matter Expert to support interdepartmental projects.

Education

High School Diploma or GED

Associate degree

Tools

Cerner

MedConnect

Job description

MedStar Health is seeking a Pharmacy Technician to support prior authorization processes under the direction of health plan pharmacists. You will gather information, communicate with patients and providers, and assist with regulatory reporting and quality initiatives.

The role requires 1–2 years of outpatient pharmacy experience, an LPT license upon hire, and a HS diploma or GED. On-site role in Waldorf, MD with competitive hourly pay.