Pharmacy Tech I- Clinical Programs

WellDyne; Lakeland (FL); On-site; USD 30,000 - 40,000; Full time

Job summary

A leading healthcare provider is seeking a Pharmacy Tech I to support clinical solutions. Responsibilities include managing prior authorizations, communicating with providers, and maintaining accurate records. The ideal candidate will have strong analytical and communication skills, with a focus on customer service.

Benefits

Medical, Dental, and Vision Benefits

401K after 90 days

Paid Time Off

Educational Reimbursement

Qualifications

• Minimum of 2 years pharmacy-related experience.
• Minimum of 2 years customer service experience.

Responsibilities

• Review clinical prior authorization requests based on protocols.
• Communicate approval and denial outcomes to providers and members.
• Assist in managing appeals.

Skills

Communication

Problem Solving

Time Management

Analytical Skills

Education

Pharmacy Technician Certification

Tools

MS Office Suite

Job description

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Summary

Pharmacy Tech I is responsible for supporting WellManaged and other clinical solutions within the Clinical Solutions team. The technician will support inbound and outbound calls with members and providers as well as support other clinical program activities. Individuals will follow all policies and procedures related to clinical reviews. They will also support PA operations and serve as a client service liaison regarding prior authorization, participating in training. This position requires strong analytical, communication, problem-solving, and decision-making skills. Attention to detail, excellent time management, and proficiency in Microsoft applications are essential.

Essential Duties and Responsibilities

1. Review clinical prior authorization requests based on protocols to determine medical necessity.
2. Answer questions based on clinical information submitted by providers.
3. Request additional information from providers as needed.
4. Refer all prior authorization denials to a clinical pharmacist for final review.
5. Assist in managing appeals.
6. Update clinical program trackers to ensure accurate records of interventions, member, and provider communications.
7. Ensure timely placement of prior authorization approvals.
8. Communicate approval and denial outcomes to providers and members in compliance with regulations.
9. Participate in the design and build of prior authorization and step therapy within systems.
10. Generate reports to support operations and oversight.
11. Serve as a subject matter expert liaison with client services.
12. Participate in training sessions.
13. Apply relevant policies, procedures, and benefit guidelines.
14. Maintain confidentiality of all PHI in accordance with laws.
15. Meet productivity, schedule adherence, and quality standards while maintaining good attendance.
16. Perform other duties as assigned.

Education and Experience

• Pharmacy Technician Certification required.
• Minimum of 2 years pharmacy-related experience.
• Minimum of 2 years customer service experience.
• Knowledge of MS Office Suite and ability to learn new systems.

Knowledge, Skills, and Abilities

• Strong communication skills (telephone, verbal, written).
• Time management and teamwork skills.
• Ability to work independently and in high-pressure environments.
• Analytical, problem-solving, and decision-making skills.
• Attention to detail and effective follow-up.
• Knowledge of claim systems, PA Hub, and Microsoft products.
• Positive attitude and excellent customer service mindset.
• Proficiency in navigating databases and software.
• Ability to handle repetitive tasks and work under pressure.
• Physical ability to sit and operate standard office equipment.

Benefits

• Medical, Dental, and Vision Benefits
• Medical Savings Account with Company match
• 401K after 90 days
• Employee Assistance Program
• Life and Supplemental Insurance
• Educational Reimbursement
• Paid Time Off
• Career Pathing

Work Environment / Physical Demands

Office environment requiring prolonged sitting, manual dexterity, and operation of standard office equipment.

Additional Details

• Seniority level: Entry level
• Employment type: Full-time
• Job function: Healthcare Provider
• Industries: Hospitals and Healthcare