Remote Certified Pharmacy Technician (CPhT) for Medicaid

Walgreens Co.; Madisonville (KY); Remote; USD 39,000 - 52,000; Full time

Benefits offered by this job

Health insurance

401(k)

Educational assistance

Job summary

Gainwell Technologies is hiring a Certified Pharmacy Technician (CPhT) for a fully remote role within the United States. You will support Rhode Island Medicaid and other state programs with claims, prior authorization, eligibility, and formulary activities, collaborating with state personnel and pharmacies.

You should have an active CPhT credential and 2+ years of relevant experience in managed care or PBM environments, with strong communication and problem-solving skills.

Qualifications

• Active Certified Pharmacy Technician credential (PTCB/CPhT, ExCPT, or equivalent)
• Two or more years of relevant pharmacy technician experience, preferably within managed care, health insurance, PBM, pharmacy benefits, Medicaid, or related healthcare environment.
• Experience with pharmacy prior authorizations, prescription claims, medication terminology, and member, provider, or pharmacy support.

Responsibilities

• Maintain day-to-day relationships with state agency personnel while supporting eligibility updates, reporting, formulary activities, and prior authorization support.
• Support state agency pharmacy programs, policies, processes, and reporting requirements, including POS and HCPCS adjudication related to medication prior authorizations.
• Review, research, and process pharmacy prior authorization requests in accordance with established criteria, policies, regulatory requirements, FDA guidance, and service-level expectations.
• Research and resolve program, member, provider, and pharmacy inquiries, including provider enrollment questions involving limited distribution drugs, while documenting activity accurately.
• Partner with internal departments on pharmacy initiatives, provide pharmacy program subject‑matter expertise, and help identify opportunities to improve quality and operational performance.

Skills

Communication

Research

Problem-solving

Organization

Computer skills

Education

CPhT/PTCB

Tools

PHARMACY management systems

Claims processing software

Job description

Gainwell Technologies is hiring a Certified Pharmacy Technician (CPhT) for a fully remote role within the United States. You will support Rhode Island Medicaid and other state programs with claims, prior authorization, eligibility, and formulary activities, collaborating with state personnel and pharmacies.

You should have an active CPhT credential and 2+ years of relevant experience in managed care or PBM environments, with strong communication and problem-solving skills.