Remote Managed Care Pharmacy Technician — PBM & Benefits

Lifetime Workforce Solutions, LLC; United States; Remote; USD 29,000 - 46,000; Full time

Job summary

CDPHP is seeking a Managed Care Pharmacy Technician to assist pharmacists in optimizing pharmacy benefits and the prescription process. This role handles live calls with members, physicians and pharmacists, supporting prior authorization work and clinical algorithm-based decisions.

Under supervision of a licensed pharmacist, you will implement and monitor pharmacy benefit tools, coordinate with internal/external stakeholders, and participate in on-call rotations to assist with after-hour issues.

Qualifications

• High school diploma with a minimum of two years’ experience in health-related field is required.
• Associates degree preferred.
• Pharmacy Technician certification (CPhT), LPN, Medical Assistant/Technologist background strongly preferred.
• Basic understanding and interpretation of medical terminology and diagnosis codes required.

Responsibilities

• Review of medical exception requests based on pharmacist-created algorithms.
• Review clinical documentation for prior authorization approval per criteria.
• Data entry and monitoring/researching member profiles for prior authorization and ad hoc reports.
• Provide information via telephone to physicians and pharmacists regarding initiatives.
• Provide real time authorization certification of prescription requests for various scenarios.

Skills

Verbal communication

Written communication

Customer service

Problem solving

Analytical skills

Microsoft Office

Independent work

On-call readiness

Education

High school diploma

Associates degree preferred

CPhT certification preferred

LPN or Medical Assistant background preferred

Tools

Facets system

Job description

CDPHP is seeking a Managed Care Pharmacy Technician to assist pharmacists in optimizing pharmacy benefits and the prescription process. This role handles live calls with members, physicians and pharmacists, supporting prior authorization work and clinical algorithm-based decisions.

Under supervision of a licensed pharmacist, you will implement and monitor pharmacy benefit tools, coordinate with internal/external stakeholders, and participate in on-call rotations to assist with after-hour issues.