Remote Pharmacy Authorization Specialist

Actalent; Houston (TX); On-site; USD 28,000 - 32,000; Full time

Benefits offered by this job

Medical, dental, vision

401(k) Retirement Plan

Life Insurance

HSA

PTO / Paid time off

Job summary

Actalent is hiring a team of remote Pharmacy Technicians to support prior authorization workflows for a large health insurance organization. This contract-to-hire role emphasizes accuracy, collaboration with pharmacists, and the use of PBM systems.

Work is fully remote with EST-based training hours and opportunities to convert to permanent benefits. Candidates should have national certifications and experience with Medicare/Medicaid prescription benefits, and a strong commitment to quality and

Qualifications

• PTCB or NHA certification required.
• Experience with Medicare/Medicaid prescription benefits.
• Background in retail, hospital, or PBM environments.
• Experience handling prior authorization workflows.
• Strong written and verbal communication.
• Ability to use multiple systems concurrently.
• Able to meet performance metrics in a high-volume setting.
• Interest in long-term career growth within a nationwide organization.
• Willingness to transition from contract to permanent with benefits.

Responsibilities

• Review prior authorization requests across health plans.
• Apply criteria to approve or deny prior authorization requests.
• Forward determinations to a pharmacist for final review.
• Enter decisions into PBM and internal systems.
• Obtain verbal authorizations from prescribers.
• Request clinical information from prescribers.
• Notify providers and members of outcomes.
• Respond to client inquiries about prescription benefits.
• Refer complex cases to specialty teams.
• Maintain detailed records of interactions and decisions.

Skills

PTCB/NHA

Medicare/Medicaid

Retail Pharmacy

Prior authorization workflows

Strong communication

Multi-system navigation

Performance metrics

Career growth

Remote teamwork

Tools

PBM systems

Microsoft Office

Outlook

Job description

Actalent is hiring a team of remote Pharmacy Technicians to support prior authorization workflows for a large health insurance organization. This contract-to-hire role emphasizes accuracy, collaboration with pharmacists, and the use of PBM systems.

Work is fully remote with EST-based training hours and opportunities to convert to permanent benefits. Candidates should have national certifications and experience with Medicare/Medicaid prescription benefits, and a strong commitment to quality and