Remote-Eligible Pharmacy Prior Authorization Technician

Capital District Physicians Health Plan Inc; City of Utica (NY); Hybrid; USD 29,000 - 45,000; Full time

Job summary

Capital District Physicians Health Plan Inc (CDPHP) is seeking a Managed Care Pharmacy Technician to support pharmacy benefits, formulary coverage, and prior authorization work under a licensed pharmacist. You will handle live calls to members, physicians, and pharmacists, and participate in on-call rotations and after-hours support.

Under supervision, you will implement formulary utilization tools, monitor PBM interfaces, and assist in data entry and ad hoc projects.

Qualifications

• High school diploma with 2 years in health field; Associates degree preferred.
• Pharmacy Technician certification (CPhT) or related credentials preferred.
• Strong communication and MS Office proficiency; understand medical terminology.

Responsibilities

• Review medical exception requests using pharmacist-created algorithms.
• Assess prior authorization requests against criteria for approval.
• Enter data and monitor member profiles for prior auth and reports.
• Provide real-time information to physicians and pharmacists about initiatives.
• Support prior authorization and medication management tasks.

Skills

Communication

Customer service

Problem solving

Analytical abilities

Professionalism

Education

CPhT certification

LPN background

Medical Assistant/Technologist background

Associates degree preferred

Tools

Facets system

Microsoft Office

Data entry systems

Job description

Capital District Physicians Health Plan Inc (CDPHP) is seeking a Managed Care Pharmacy Technician to support pharmacy benefits, formulary coverage, and prior authorization work under a licensed pharmacist. You will handle live calls to members, physicians, and pharmacists, and participate in on-call rotations and after-hours support.

Under supervision, you will implement formulary utilization tools, monitor PBM interfaces, and assist in data entry and ad hoc projects.