Remote Certified Pharmacy Technician for Medicaid Programs

Gainwell Technologies LLC; Massachusetts; Remote; USD 39,000 - 52,000; Full time

Benefits offered by this job

Medical benefits

Dental benefits

Vision benefits

401(k) match

Educational assistance

Generous vacation policy

Job summary

Gainwell Technologies LLC in the United States seeks a Certified Pharmacy Technician (CPhT) to support Rhode Island Medicaid and other state pharmacy programs through claims, prior authorization, eligibility, formulary, and program operations.

This fully remote role involves collaboration with state agencies, providers, pharmacies, and internal teams to research and resolve pharmacy-related issues and ensure accurate program administration.

Qualifications

• Certified Pharmacy Technician credential (PTCB/CPhT, ExCPT, or equivalent) required.
• Two or more years of relevant pharmacy technician experience, preferably in managed care, health insurance, PBM or Medicaid.
• Experience with pharmacy prior authorizations, prescription claims, medication terminology, and member/provider/pharmacy support.
• Experience with POS claims, HCPCS, provider enrollment, formularies, eligibility, or related pharmacy program operations is highly desirable.
• Strong communication, research, problem-solving, computer and organizational skills for a fast-paced remote environment.

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 line with established criteria and regulatory requirements.
• Research and resolve program, member, provider, and pharmacy inquiries, documenting activity accurately.
• Partner with internal departments on pharmacy initiatives and help identify opportunities to improve quality and operational performance.

Skills

CPhT certification

2+ years pharmacy experience

pharmacy prior authorizations

prescription claims

communication skills

Job description

Gainwell Technologies LLC in the United States seeks a Certified Pharmacy Technician (CPhT) to support Rhode Island Medicaid and other state pharmacy programs through claims, prior authorization, eligibility, formulary, and program operations.

This fully remote role involves collaboration with state agencies, providers, pharmacies, and internal teams to research and resolve pharmacy-related issues and ensure accurate program administration.