Pharmacy Technician - Prior Authorization - Work From Home

CVS Health; Oklahoma; Hybrid; USD 25,000 - 44,000; Full time

Benefits offered by this job

Medical insurance

Dental and Vision

Paid time off

Retirement savings options

Wellness programs

Job summary

CVS Health is seeking a Pharmacy Technician to support Medicaid and Medicare pharmacy services, including intake and processing of authorization requests, and ensure compliance with CMS regulations.

The role emphasizes coordination, documentation, and communication with physicians, health plans, and pharmacists; requires certification, strong software skills, and a 40-hour work week with full-time benefits.

Qualifications

• National Pharmacy Technician certification and home state license in good standing.
• Proficiency with pharmacy software and computerized systems.
• Excellent verbal and written communication skills.
• Experience with Windows-based software applications.
• Protects the confidentiality of member information per policy.

Responsibilities

• Coordinates Medicaid/Medicare pharmacy services intake and processing of authorization requests.
• Promotes and supports quality effectiveness of healthcare and Pharmacy Services.
• Evaluates, authorizes approval, and communicates decisions for pharmacy requests per clinical guidelines.
• Communicates decisions to physicians, members, and pharmacists.
• Performs clinical and non-medical research to support requests, including eligibility and benefits verification.
• Maintains documentation meeting risk management, regulatory, and accreditation requirements.

Skills

Verbal communication

Written communication

Privacy/confidentiality

Windows software

Education

High School diploma, G.E.D.

Tools

Pharmacy software

Proprietary systems

Job description

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time.

Position Summary

• Supports comprehensive coordination of Medicaid and/or Medicare pharmacy services including intake and processing of pharmacy authorization requests.
• Promotes and supports quality effectiveness of healthcare and Pharmacy Services.
• Evaluates, authorizes approval, and communicates decisions for pharmacy requests according to clinical guidelines.
• Evaluates and authorizes approval of pharmacy requests received by telephone, facsimile, and/or other means using client clinical criteria.
• Determines appropriateness for medications. Communicates decision to physicians, physician's office staff, medical management staff, members, and/or pharmacists.
• Will perform clinical research to support request.
• Performs non-medical research including eligibility verification, COB, and benefits verification.
• Maintains accurate and complete documentation of required information that meets risk management, regulatory, and accreditation requirements.
• Process requests in compliance with various laws and CMS regulations and company policies and procedures.
• May communicate with Aetna Case Managers, Health Plan Staff, External Pharmacies and Health Care Providers.
• Promotes communication, both internally and externally, to enhance effectiveness of medication therapy management services.
• Sedentary work involving significant periods of sitting, talking, hearing, and keying.
• Escalates requests to Pharmacist when request requires extensive clinical review or denial.

Required Qualifications

• National Pharmacy Technician certification and Home State License, current and in good standing, are required.
• Proficiency in computerized pharmacy systems and software applications.
• Excellent verbal and written communication skills.
• Experience with Windows-based software applications.
• Utilizes various proprietary systems to build, research, process and enter requests.
• Protects the confidentiality of member information and adheres to company policies regarding confidentiality.

Preferred Qualifications

• High volume call center and production unit.
• Experience in retail, hospital, facility or call center is preferred.

Education

High School diploma, G.E.D.

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is:

$18.50 - $31.72

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.

Additional details about available benefits are provided during the application process and on Benefits Moments.

We anticipate the application window for this opening will close on: 09/19/2026

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.