Remote Pharmacy Authorization Technician | UM & Systems Expert

Kelly; City of Rochester (NY); À distance; USD 23 000 - 32 000; Plein temps

Avantages offerts par ce poste

Medical, dental, vision

Transit benefit

Paid holidays

Retirement savings plan

Résumé du poste

Kelly is seeking a Pharmacy Authorization Technician to support a leading healthcare organization in Greece, NY. This contract role is remote but candidates must reside in the area, with a standard 8am–5pm schedule, Monday–Friday and occasional weekend coverage during the 6–8 month assignment.

You will process and review pharmacy and medical authorization requests, prepare UM case materials, serve as a subject matter expert for related systems, coordinate with pharmacies and physician offices,

Qualifications

• Experience or training in pharmacy operations, healthcare administration, or a related field.

Responsabilités

• Process and review pharmacy and medical authorization requests per policy.
• Prepare, interpret, and document cases for utilization management reviews and determinations.
• Act as a subject matter expert for applications and systems used in the authorization process.
• Serve as a resource for staff regarding member-specific contract benefits, policies, and procedures.
• Conduct medication authorization, exception, and medical necessity reviews to determine coverage and route cases for final determination.
• Issue verbal and written notifications to members.
• Review prescription and medical benefit coverage, document medication histories, and identify missing information.

Connaissances

Pharmacy operations

Healthcare administration

Attention to detail

Communication skills

Customer service

Description du poste

Kelly is seeking a Pharmacy Authorization Technician to support a leading healthcare organization in Greece, NY. This contract role is remote but candidates must reside in the area, with a standard 8am–5pm schedule, Monday–Friday and occasional weekend coverage during the 6–8 month assignment.

You will process and review pharmacy and medical authorization requests, prepare UM case materials, serve as a subject matter expert for related systems, coordinate with pharmacies and physician offices,