Pharmacy Technician
Actalent
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Benefits offered by this job
Job summary
Actalent is seeking a Pharmacy Technician for a contract role based in Dallas, TX, with fully remote work options. You will track and triage coverage determination requests for prior authorizations and Medicare Part D recipients, review requests, gather clinical information, and document decisions in the PBM system while communicating clearly with providers and members.
The role requires at least 1 year of pharmacy experience, a current state Pharmacy Technician license, and familiarity with PBM
Qualifications
- High school diploma or equivalent.
- 1 year experience in a retail, hospital, or mail order pharmacy setting.
- Current state Pharmacy Technician license.
- Experience handling prior authorization or coverage determination processes in a pharmacy or PBM environment.
- Ability to track and triage coverage determination requests efficiently.
- Skill in obtaining verbal authorizations and requesting detailed clinical information from prescribers.
- Ability to approve coverage determinations based on defined criteria and guidelines.
- Proficiency in documenting decisions in a PBM system.
- Strong communication skills to notify providers and members of coverage decisions and respond to client inquiries.
- Attention to detail and accuracy in data entry and recordkeeping.
Responsibilities
- Track and triage all coverage determination requests submitted by providers for prior authorizations and Medicare Part D recipients.
- Review coverage determination requests and determine when a pharmacist review is required based on established guidelines.
- Obtain verbal authorizations from prescribers and request detailed clinical information to support coverage determinations.
- Approve coverage determination requests in accordance with defined criteria and organizational policies.
- Enter and document coverage determination decisions accurately in the PBM system.
- Notify providers and members of coverage determination decisions in a timely and professional manner.
- Respond to client inquiries regarding authorization approvals and PBM online processes.
- Refer coverage determination requests for specialty drugs to the appropriate delegated vendor or client for processing.
- Contact providers to obtain additional information needed to complete coverage determination reviews.
- Maintain thorough and accurate records of all interactions and decisions related to coverage determination requests.
Skills
Education
Tools
Job description
This Pharmacy Technician role focuses on tracking and triaging coverage determination requests for prior authorizations and Medicare Part D recipients. You will support the pharmacy benefit process by reviewing requests, gathering clinical information, and documenting decisions in the pharmacy benefit management (PBM) system while providing clear communication to providers and members.
This Pharmacy Technician role focuses on tracking and triaging coverage determination requests for prior authorizations and Medicare Part D recipients. You will support the pharmacy benefit process by reviewing requests, gathering clinical information, and documenting decisions in the pharmacy benefit management (PBM) system while providing clear communication to providers and members.
- Track and triage all coverage determination requests submitted by providers for prior authorizations and Medicare Part D recipients.
- Review coverage determination requests and determine when a pharmacist review is required based on established guidelines.
- Obtain verbal authorizations from prescribers and request detailed clinical information to support coverage determinations.
- Approve coverage determination requests in accordance with defined criteria and organizational policies.
- Enter and document coverage determination decisions accurately in the PBM system.
- Notify providers and members of coverage determination decisions in a timely and professional manner.
- Respond to client inquiries regarding authorization approvals and PBM online processes.
- Refer coverage determination requests for specialty drugs to the appropriate delegated vendor or client for processing.
- Contact providers to obtain additional information needed to complete coverage determination reviews.
- Maintain thorough and accurate records of all interactions and decisions related to coverage determination requests.
- High school diploma or equivalent.
- At least 1 year of experience in a retail, hospital, or mail order pharmacy setting.
- Current state Pharmacy Technician license.
- Experience handling prior authorization or coverage determination processes in a pharmacy or PBM environment.
- Ability to track and triage coverage determination requests efficiently.
- Skill in obtaining verbal authorizations and requesting detailed clinical information from prescribers.
- Ability to approve coverage determinations based on defined criteria and guidelines.
- Proficiency in documenting decisions in a pharmacy benefit management (PBM) system.
- Strong communication skills to notify providers and members of coverage decisions and respond to client inquiries.
- Attention to detail and accuracy in data entry and recordkeeping.
- National Certification from the Pharmacy Technician Certification Board (CPhT) preferred.
- Familiarity with Medicare Part D coverage determination and prior authorization processes.
- Experience working with PBM online tools and systems.
- Ability to manage multiple requests and prioritize workload in a fast-paced environment.
- Strong customer service orientation when working with providers, prescribers, and members.
The role operates in a pharmacy or pharmacy benefit management environment that may support retail, hospital, or mail order pharmacy operations. You will work extensively with pharmacy benefit management (PBM) systems and online tools to process and document coverage determinations. The position involves frequent phone and electronic communication with prescribers, providers, clients, and members, requiring a professional and service-oriented approach. Work hours and shifts may vary based on operational needs, and the setting typically follows standard professional dress expectations appropriate for a pharmacy or office-based healthcare environment.
This is a Contract position based out of Dallas, TX.
The pay range for this position is $20.00 - $23.00/hr.
Individual compensation offered for this position within this range will depend on many factors, including qualifications, skills, relevant experience, job knowledge, geographic location, internal equity, and other pertinent job-related factors.
Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: Medical, dental & vision Critical Illness, Accident, and Hospital 401(k) Retirement Plan Pre-tax and Roth post-tax contributions available Life Insurance (Voluntary Life & AD&D for the employee and dependents) Short and long-term disability Health Spending Account (HSA) Transportation benefits Employee Assistance Program Time Off/Leave (PTO, Vacation or Sick Leave)
This is a fully remote position.
This position is anticipated to close on Oct 19, 2026.
Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 20,000 consultants and 5,000 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500. We are proud to be an Engineering News-Record (ENR) Top 500 Design Firm for our engineering design services and a ClearlyRated Best of Staffing® winner for both client and talent service.
The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please email actalentaccommodation@actalentservices.com for other accommodation options.
Pursuant to the San Francisco Fair Chance Ordinance, for all positions located in the city and county of San Francisco, we will consider for employment qualified applicants with arrest and conviction records.
It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.
We may use Artificial Intelligence (AI) to support parts of our hiring process, including sourcing, screening, and evaluating candidates. AI helps assess applications and qualifications, but final decisions are made by our hiring team. By applying, you acknowledge and agree that your application may be reviewed using AI tools.
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