Pharmacy Tech I: PA & Clinical Solutions Specialist

WellDyne; United States; Remote; USD 38,000 - 56,000; Full time

Benefits offered by this job

Medical, Dental and Vision Benefits

Medical Savings Account Options with 2

401K after 90 days of employment

Employee Assistance Program

Life and Supplemental insurance

Educational Reimbursement

Paid Time Off

Career Pathing

Job summary

WellDyne is seeking a Pharmacy Tech I to support the Clinical Solutions team, handling inbound/outbound calls with members and providers and assisting with prior authorization operations. You will follow policies, maintain PHI confidentiality, and contribute to training and process improvements.

The ideal candidate has at least 2 years in pharmacy and 2 years in customer service, with strong analytical and time-management skills, proficiency in MS Office, and the ability to work both

Qualifications

• At least 2 years of pharmacy-related experience.
• At least 2 years of customer service-related experience.
• MS Office Suite knowledge and ability to learn new computer systems.

Responsibilities

• Review prior authorization requests to determine medical necessity.
• Answer questions based on clinical information submitted by providers.
• Request additional information from providers as needed for review.
• Direct denials to a clinical pharmacist for final review.
• Assist in processing appeals.
• Update clinical program trackers and communications logs.
• Ensure PA approvals are recorded accurately and timely.
• Communicate approval/denial outcomes to providers and members, per regs.
• Participate in design and build of PA and step therapy in key systems.
• Run/reports to support operations and oversight.
• Serve as SME liaison with client services.
• Participate in training and apply policies and eligibility rules.
• Maintain PHI confidentiality per state/federal law.
• Meet productivity, schedule adherence, and quality standards.
• Other duties as assigned.

Skills

Telephone communication

Verbal communication

Written communication

Time management

Teamwork

Independent work

Analytical skills

Attention to detail

Multi-tasking

Problem solving

Customer service

MS Office proficiency

Tools

MS Office Suite

Job description

WellDyne is seeking a Pharmacy Tech I to support the Clinical Solutions team, handling inbound/outbound calls with members and providers and assisting with prior authorization operations. You will follow policies, maintain PHI confidentiality, and contribute to training and process improvements.

The ideal candidate has at least 2 years in pharmacy and 2 years in customer service, with strong analytical and time-management skills, proficiency in MS Office, and the ability to work both