Prior Authorization Pharmacy Tech - Impact & Coordination

Devoted Health; United States; On-site; USD 59,887,000 - 75,217,000; Full time

Benefits offered by this job

Health, dental, vision benefits

Paid time off

$100 monthly mobile/internet stipend

Stock options for all employees

Bonus eligibility for most roles

Parental leave program

401K program

Job summary

Devoted Health is seeking a Pharmacy Technician to support medical management operations for our health plan. You will work with networks, providers, and members, handling prior authorizations and documentation with a focus on accuracy and service.

This role requires strong organizational skills and the ability to manage multiple tasks in a fast-paced startup environment. Responsibilities include triaging requests, applying product strategies, coordinating with hospitals and providers, and

Qualifications

• Certified Pharmacy Technician (CPhT) with 3+ years of experience.
• Desire to work with aging patient populations.
• Experience with Medicare Part B operations (pharmacy help desk, utilization management, prior authorizations).
• Experience caring for Medicare patients.
• Proficient in Gmail / G Suite.
• Organized with high attention to detail.
• Prior experience in utilization management preferred.

Responsibilities

• Review and determine prior authorization requests based on policies and decision trees.
• Triage and enter incoming prior authorization requests from provider offices.
• Apply product strategies and steer utilization of Part B medications.
• Reach out to hospitals and provider offices to obtain clinical documentation.
• Contact provider groups and members to communicate clinical decisions.
• Answer member questions when alternate treatments are needed.
• Provide operational support for medical management to enable efficient decisions.
• Serve as main contact for internal and external stakeholders.
• Support offshore clinical partners in workflows.
• Interpret plan benefits and enter overrides for proper claim adjudication.

Skills

CPhT

Aging patient care

Medicare Part B operations

Medicare patient care

Gmail / G Suite

High attention to detail

Utilization management (preferred)

Tools

Gmail / G Suite

Job description

Devoted Health is seeking a Pharmacy Technician to support medical management operations for our health plan. You will work with networks, providers, and members, handling prior authorizations and documentation with a focus on accuracy and service.

This role requires strong organizational skills and the ability to manage multiple tasks in a fast-paced startup environment. Responsibilities include triaging requests, applying product strategies, coordinating with hospitals and providers, and