Remote Medicaid PA Specialist (CPhT)

Actalent; Eagan (MN); Remote; USD 25,000 - 30,000; Full time

Benefits offered by this job

Medical, dental & vision

401(k) Retirement Plan

Life Insurance (Voluntary)

Paid time off (PTO)

Job summary

Actalent is seeking a Certified Pharmacy Technician for a fully remote, one-year contract focused on Medicaid prior authorization. You will assess requests, document decisions, and communicate formulary options to prescribers and pharmacy staff, while maintaining high service levels.

Requirements include an active state tech license, a PTCB/NHA certification, and 1+ year in retail or call center pharmacy settings. Training is provided and extension opportunities exist.

Qualifications

• Active state pharmacy technician registration or license.
• National pharmacy technician certification (CPhT) through PTCB or NHA.
• High School Diploma or GED.
• At least 1 year of experience in a retail or call center pharmacy environment.

Responsibilities

• Evaluate and authorize Medicaid prior authorization requests by telephone using clinical criteria.
• Determine medication appropriateness based on established guidelines and client criteria.
• Communicate coverage decisions and formulary alternatives to prescribers and pharmacists.
• Document prior authorization outcomes accurately in the pharmacy system.
• Escalate complex cases to a Pharmacist following established procedures.
• Record inquiries and outcomes, and respond to prescribers and staff as needed.
• Process and review coverage determinations for faxed requests within SLA timelines.
• Navigate multiple systems to research and process requests.
• Deliver high level customer service in a fast-paced remote environment.

Skills

Customer service

Clear communication

Attention to detail

Education

High School Diploma or GED

National pharmacy technician certification (CPhT)

Tools

Pharmacy systems

Job description

Actalent is seeking a Certified Pharmacy Technician for a fully remote, one-year contract focused on Medicaid prior authorization. You will assess requests, document decisions, and communicate formulary options to prescribers and pharmacy staff, while maintaining high service levels.

Requirements include an active state tech license, a PTCB/NHA certification, and 1+ year in retail or call center pharmacy settings. Training is provided and extension opportunities exist.