Remote Medicaid Prior-Auth Pharmacy Technician

Actalent; Houston (TX); Remote; USD 25,000 - 30,000; Full time

Benefits offered by this job

Remote work

Benefits

Long-term growth

Job summary

Actalent is seeking a Certified Pharmacy Technician for a fully remote contract role based in Houston, TX. You will evaluate Medicaid prior authorization requests, determine medication appropriateness, and communicate coverage decisions to prescribers and pharmacy staff.

Join a high-volume call center with structured training and potential extension; active state registration and CPhT certification are required, with 1+ year of retail or call center pharmacy experience preferred.

Qualifications

• Active state pharmacy technician registration verified.
• National pharmacy technician certification (CPhT) through PTCB or NHA.
• High School Diploma or GED required.
• 1+ year in retail or call center pharmacy environment; 3+ years preferred.

Responsibilities

• Evaluate Medicaid prior authorization requests from prescribers by telephone using criteria.
• Determine medication appropriateness based on guidelines and client criteria.
• Communicate coverage decisions to physicians, staff, and pharmacists clearly.
• Document all prior authorization outcomes in the pharmacy system accurately.
• Explain PA criteria, coverage, and formulary alternatives to prescribers and staff.
• Escalate to a Pharmacist when extensive review or denial is needed.
• Record inquiries and outcomes; provide responses as needed.
• Review and process coverage determinations for faxed requests per SLA.

Skills

Retail pharmacy experience

Education

State pharmacy technician registration

CPhT certification (PTCB or NHA)

High School Diploma or GED

Job description

Actalent is seeking a Certified Pharmacy Technician for a fully remote contract role based in Houston, TX. You will evaluate Medicaid prior authorization requests, determine medication appropriateness, and communicate coverage decisions to prescribers and pharmacy staff.

Join a high-volume call center with structured training and potential extension; active state registration and CPhT certification are required, with 1+ year of retail or call center pharmacy experience preferred.