Pharmacy Technician / Pharm Tech Apprenticeship (Hopkins)

Walgreens; Winsted (MN); Remote; USD 65,000 - 85,000; Full time

Job summary

Prime Therapeutics is hiring a Senior Clinical Pharmacy Technician Sr - MCO Clinical Liaison - Remote to support NY Medicaid. The role focuses on handling complex coordination for prior authorizations and benefits, educating providers on NYRx and Medicaid Pharmacy programs, and ensuring accurate PA processing and documentation.

The successful candidate will assist with case reviews, maintain compliance with guidelines, and collaborate with internal teams to resolve provider inquiries while

Qualifications

• Evaluate and process prior authorization requests using clinical criteria.
• Document PA outcomes clearly and accurately in the system.
• Lead complex care coordination for NY Medicaid members via provider outreach.

Responsibilities

• Evaluate and process prior authorization (PA) requests, including determining medication appropriateness, applying clinical criteria, and communicating decisions to providers, pharmacies, and internal stakeholders.
• Research, resolve, and document PA outcomes and complex provider/member inquiries while ensuring accuracy and compliance with system and documentation standards.
• Lead complex care coordination efforts for New York Medicaid members, including inbound and outbound provider outreach, claim resolution, coverage clarification, and facilitation of prior authorizations to support continuity of care.

Skills

PA processing

Clinical criteria application

Provider outreach

Documentation accuracy

Education

Licensed Pharmacy Technician

Job description

Licensed Remote Pharmacy Technician (Texas Only)

Home
Full time
R-17319
At Prime Therapeutics (Prime), we are a different kind of PBM, with a purpose beyond profits and a unique ability to connect care for those we serve. Looking for a purpose-driven career? Come build the future of pharmacy with us.
**Job Posting Title**
Clinical Pharmacy Technician Sr. - MCO Clinical Liaison - Remote
**Job Description**
The Senior Clinical Pharmacy Technician assists with complex care coordination as it relates to pharmacy benefits for New York Medicaid members. Efforts may include claim submission, coverage parameters, and/or prior authorization requests. Additional outreach efforts may be needed to educate providers on NYRx, the Medicaid Pharmacy Program.

• Evaluate and process prior authorization (PA) requests, including determining medication appropriateness, applying clinical criteria, and communicating decisions to providers, pharmacies, and internal stakeholders.
• Research, resolve, and document PA outcomes and complex provider/member inquiries while ensuring accuracy and compliance with system and documentation standards.
• Lead complex care coordination efforts for New York Medicaid members, including inbound and outbound provider outreach, claim resolution, coverage clarification, and facilitation of prior authorizations to support continuity of care.