Pharmacy Prior Authorization Technician - Specialty Medications

Maine Medical Center; Westbrook (ME); Vor Ort; USD 30.000 - 40.000; Vollzeit

Benefits dieser Stelle

Paid parental leave

Flexible work options

Student loan assistance

Professional development opportunities

Well-being resources

Zusammenfassung

MaineHealth is seeking a Pharmacy Prior Authorization Technician to coordinate and process prior authorizations for prescription medications. The role collaborates with providers, pharmacists, payers, and patients to facilitate PA submissions and documentation in the EHR.

Initially focusing on specialty medications in specific clinics, the role will expand over time to support the clinical team and reduce treatment delays, improving medication access across Maine and New Hampshire.

Qualifikationen

• High school diploma or equivalent required.
• State Pharmacy Technician license or eligibility; CPhT certification required.
• One year of licensed pharmacy technician experience.

Aufgaben

• Review medication orders needing prior authorization, especially specialty meds.
• Initiate and complete PA requests through electronic portals.
• Communicate with insurance companies to gather coverage requirements and status updates.
• Collaborate with providers and pharmacists to obtain clinical documentation for PA submissions.
• Document PA status, approvals, denials, and follow-ups in Epic using SmartPhrases.
• Notify providers of PA outcomes and assist with alternative medication strategies when needed.
• Track and manage open prior authorizations to ensure timely resolution and refill coordination.
• Support clinic staff and patients with status updates or coverage information as allowed.
• Maintain up-to-date knowledge of payer formulary changes and authorization requirements.
• Participate in continuous quality improvement and workflow optimization efforts.

Ausbildung

High school diploma or equivalent

Tools

CoverMyMeds

Surescripts

Epic

Jobbeschreibung

Description

MaineHealth Corporate

Professional - Clinical

Req #: 96191

Summary:

The Pharmacy Prior Authorization Technician is responsible for coordinating and processing prior authorizations (PAs) for prescription medications to ensure timely patient access to treatment. Working closely with providers, pharmacists, payers, and patients, the technician utilizes the EHR and payer portals to facilitate and document the PA process.

This role is key to supporting the clinical team in minimizing treatment delays and improving medication access. The role will initially focus on Specialty Medications in specific clinics but is expected to expand and change over time.

Key Responsibilities:

• Review medication orders (especially specialty medications) needing prior authorization.
• Initiate and complete prior authorization requests through electronic portals (e.g., CoverMyMeds, Surescripts, payer websites).
• Communicate with insurance companies to gather coverage requirements and status updates.
• Collaborate with providers and pharmacists to obtain necessary clinical documentation for PA submissions.
• Document PA status, approvals, denials, and follow-ups within Epic using SmartPhrases and encounters.
• Notify providers of PA outcomes and assist with alternative medication strategies when necessary.
• Track and manage open prior authorizations to ensure timely resolution and refill coordination.
• Support clinic staff and patients by providing status updates or coverage information as allowed.
• Maintain up-to-date knowledge of payer formulary changes and authorization requirements.
• Participate in continuous quality improvement and workflow optimization efforts.

Required Minimum Knowledge, Skills, and Abilities (KSAs)

1. Education: High school diploma or equivalent required.
2. License/Certifications: Current or eligible for applicable state(s) license as a Pharmacy Technician. CPhT certification is required.
3. Experience: One year of experience as a licensed pharmacy technician.

Additional Information

MaineHealth is committed to fostering a supportive, inclusive environment where care team members can thrive while making a meaningful impact in the communities we serve across Maine and New Hampshire. We offer competitive benefits including paid parental leave, flexible work options, student loan assistance, professional development opportunities, and well-being resources-so you can grow your career while feeling supported both personally and professionally.

We recognize the value each team member brings to our organization. Any offer of employment will depend on qualifications such as skills, relevant experience, education, certifications, and other job-related factors. The base range is an estimate and does not reflect the full value of our total compensation package.

The pay range for this position is $21.97 to $29.28 per hour.

Compensation for part-time positions is determined on a prorated basis consistent with the scheduled hours and applicable full-time equivalent (FTE).

In addition to base pay, MaineHealth offers comprehensive benefits, recognition programs, career growth opportunities, and, where applicable, shift differentials or other incentives.

If you have questions about this role, please contact [email protected]

Notice Regarding Maine Employer Surveillance Statute:

Pursuant to Maine's Employer Surveillance Statute, prospective care team members are notified that MaineHealth may monitor, collect, record, review, or retain information related to the use of its systems, networks, applications, files, data, communications platforms (including notified recordings), smart badges, building access, company vehicle GPS data, business calls, and workplace security cameras.

Information collected may be used for legitimate business purposes, including security, safety, compliance, investigations, training, quality assurance, and operational management.