Prior Authorization Pharmacy Specialist

CVS Health Corporation; Phoenix (AZ); Remote; USD 25,000 - 49,000; Full time

Job summary

CVS Health Corporation is seeking a Pharmacy Technician for Prior Authorization to support reviews for providers and pharmacies. This full-time role processes PA requests by phone, fax, or electronic means, applying guidelines and documentation to ensure accurate decisions.

You will handle calls, maintain documentation, and adhere to NCQA requirements while working with multiple systems. The schedule is 40 hours weekly with potential shifts based on company needs, and remote work from home with

Qualifications

• National Pharmacy Technician certification and Arizona license required.
• 1–5+ years of Pharmacy Prior Authorization processing experience.
• Ability to Multi-task and prioritize work.
• Good organization skills.

Responsibilities

• Process prior authorization requests by phone, fax, or electronically using criteria and guidelines.
• Proactively complete prior authorization approvals and denials that are due to expire and maintain documentation.
• Review potential denial language to meet NCQA requirements.
• Follow prior authorization workflow, policies, and procedures during the day.
• Answer high-volume calls from provider offices, pharmacies, and internal partners about PA status.
• Maintain a balance of productivity, quality and timeliness of work.
• Participate in training and continuing education as required.
• Participate in team/departmental meetings as required.

Skills

Pharmacy Prior Authorization

National Pharmacy Technician cert

Arizona license

Multi-tasking

Prior Authorization processing

Organizational skills

Education

High School diploma / GED

Tools

AS400

Microsoft Excel

Microsoft Word

Microsoft Outlook

Job description

CVS Health Corporation is seeking a Pharmacy Technician for Prior Authorization to support reviews for providers and pharmacies. This full-time role processes PA requests by phone, fax, or electronic means, applying guidelines and documentation to ensure accurate decisions.

You will handle calls, maintain documentation, and adhere to NCQA requirements while working with multiple systems. The schedule is 40 hours weekly with potential shifts based on company needs, and remote work from home with