Remote Contract Clinical Data & PA Specialist

Prescryptive Health, Inc.; Connecticut; Remote; USD 28,000 - 55,000; Full time

Job summary

Prescryptive Health, Inc. is seeking a Contract Clinical Services Support Technician to maintain clinical drug lists and prior authorization documents, resolve drug list and benefit setup questions, and prepare reports and client business review materials.

You will own recurring maintenance and reporting, with pharmacist or clinical team review at defined quality checkpoints. This is a contract opportunity for an operational role.

Qualifications

• High school diploma or equivalent and active CPhT certification through PTCB or ExCPT, with state registration or licensure where required.
• 2 years of PBM clinical services experience (utilization management, coverage review, or prior authorization resolution).
• Experience with mail order and specialty pharmacy operations, formulary, drug lists, and NDC identifiers.
• Hands-on experience with formulary or drug information databases and PBM platforms.
• Strong Microsoft Excel and PowerPoint skills to compare drug list data and prepare reports.
• Attention to detail and accuracy in maintaining claims adjudication data and preparing client-facing materials.

Responsibilities

• Synchronize Medispan drug lists in the drug list management platform.
• Update PA coverage criteria documents with formulary updates and client customizations.
• Investigate claim rejections related to drug list platform configuration and resolve drug list and benefit setup questions; prepare and publish coverage policies files and client drug lists under QA review.
• Establish quality control checkpoints for PA updates and PA printing, with pharmacist or clinical team review before finalization.
• Analyze, generate, and distribute medication lists and reports; prepare client-facing clinical materials including disruption analyses for annual/quarterly reviews.
• Coordinate with pharmacists, operations teams, and internal stakeholders to meet deadlines.
• Identify opportunities to improve accuracy and efficiency through technology, automation, and AI-enabled tools.

Skills

Attention to detail

Clear communication

Excel

PowerPoint

Team coordination

Education

Certified Pharmacy Technician (CPhT) certification

State registration/licensure (as required)

Tools

Medispan

MMIT platform

RxLogic

Job description

Prescryptive Health, Inc. is seeking a Contract Clinical Services Support Technician to maintain clinical drug lists and prior authorization documents, resolve drug list and benefit setup questions, and prepare reports and client business review materials.

You will own recurring maintenance and reporting, with pharmacist or clinical team review at defined quality checkpoints. This is a contract opportunity for an operational role.