Pharmacy Technician - Prior Authorizations - Work From Home

CVS Health; Austin (TX); On-site; USD 26,000 - 48,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

Paid time off

Retirement savings options

Wellness programs

Other eligibility-based resources

Job summary

CVS Health is seeking a Pharmacy Technician for Prior Authorization at our Austin, TX location. You will process prior authorization requests by phone, fax, or electronically, use criteria and guidelines to support decisions, and maintain accurate documentation.

The role requires national certification and state license, 1–5+ years PA experience, strong organization, multitasking, and solid computer skills across multiple systems.

Qualifications

• National Pharmacy Technician certification and Arizona or applicable state Pharmacy Technician license, current and in good standing.
• 1–5+ years of Pharmacy Prior Authorization processing experience.
• Ability to multi-task and prioritize work.
• Good organization skills.

Responsibilities

• Process prior authorization requests received by phone, fax, or electronically using criteria and guidelines.
• Proactively complete prior authorization approvals and denials and maintain documentation.
• Review potential denial language to ensure NCQA requirements are met.
• Follow prior authorization workflow, policies and procedures during the day.
• Answer high volume inquiry calls from providers, pharmacies and internal partners; communicate status.
• Maintain productivity, quality and timeliness of work.
• Participate in training and continuing education as required.
• Participate in team/department meetings as required.
• Proficient in drug names, medical terminology, and navigating multiple computer resources.
• Demonstrate strong written and verbal communication.

Skills

Multi-tasking

Prioritization

Organizational skills

Verbal & written communication

PC navigation

Education

National Pharmacy Technician certification

Arizona or applicable state Pharmacy Technician license

Tools

AS400

Microsoft Excel

Microsoft Word

Microsoft Outlook

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

• Processes prior authorization requests received by phone, fax, or electronically and utilizes various computer resources, existing criteria, and medication guidelines to perform clinical research to support prior authorization reviews.
• Proactively completes prior authorization approvals and denials that are due to expire and maintains complete, timely, and accurate documentation.
• Reviews potential prior authorization denial language to ensure NCQA requirements are met.
• Follows prior authorization workflow, policies, and procedures during the course of the workday.
• Answers a potentially high volume of prior authorization inquiry calls from provider's offices, pharmacies, and internal partners and uses various computer resources to communicate prior authorization status or decisions.
• Maintains a balance of productivity, quality and timeliness of work.
• Participates in training and continuing education as required.
• Participates in team/departmental meetings as required.
• Excellent attendance is a must.
• Successful pharmacy technicians will be proficient in drug name and diagnosis pronunciation, recognizing medical terminology, and navigating multiple computer resources to document conversations and prior authorization decisions.
• Successful pharmacy technicians will possess good written and verbal communication skills.
• Hours of operation for Aetna Pharmacy Prior Authorization are between 5:00am to 8:30pm (may vary by time zone). Pharmacy Technicians work 8 hours shifts that may fall in between these hours of operations. Overnight shifts may also be available, but not guaranteed. Work schedule is approximate, and hours/days may change based on company needs. All full-time employees are required to complete forty (40) hours per week as scheduled, including on weekends and holidays. Part time positions are not available. Position requires the ability to work extended hours when necessary.
• Rotating weekend schedule may be required.
• Candidate must have their own home internet access with minimum speed of 100mbps download (internet can be hard wired with Ethernet cord).
• Candidate must also have a secure workspace/office in their home.
• Candidate must have high level skill with working with PC (ex. using mouse and keyboard, accessing and navigating through multiple systems and screens).

Required Qualifications

• National Pharmacy Technician certification and Arizona or applicable state Pharmacy Technician license, current and in good standing, are required and must be maintained
• Between 1-5+ years of Pharmacy Prior Authorization processing experience
• Ability to Multi-task and prioritize work
• Ability to adjust based on business or department needs
• Good organization skills

Preferred Qualifications

• Retail or Hospital experience
• Managed Care or Medicaid experience
• AS400 experience
• Proficiency in using computerized resources and software applications
• Proficiency with Microsoft applications (Excel, Word, and Outlook)
• Knowledge in pharmacy practices, procedures, and ability to read and understand clinical information
• Working knowledge of drug dosage forms, drug strength, generic and brand name equivalent.

Education

High School diploma, G.E.D.

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

$18.50 - $35.29

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.

Great Benefits For Great People

• medical, dental, and vision coverage
• paid time off
• retirement savings options
• wellness programs
• other resources, based on eligibility

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.

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

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

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