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Actalent is seeking a dedicated Pharmacy Technician for a remote role operating in the EST timezone. The position focuses on reviewing Prior Authorizations for coverage determinations within a Pharmacy Services department for a major health insurer, with approvals or denials routed to pharmacists for final review.
Responsibilities include tracking requests, obtaining verbal authorizations, entering decisions in the PBM system, and communicating outcomes to providers and members.
We are seeking a dedicated Pharmacy Technician to join our team in a remote capacity, operating within the EST timezone. The primary role involves reviewing Prior Authorizations for coverage determination within a Pharmacy Services department associated with a large healthcare insurance company. Technicians are responsible for approving or denying requests and forwarding them to pharmacists for final review. This role involves minimal phone work, primarily outbound calls.
Review and track coverage determination requests.
Obtain verbal authorizations and approve requests based on specified criteria.
Enter decisions into the PBM system and notify providers and members of outcomes.
Respond to client inquiries and refer requests for specialty drugs.
Contact providers for additional information and notify stakeholders of decision outcomes.
Assist with inbound and/or outbound patient or physician calls, if necessary.
High School diploma or GED.
Current Pharmacy Registration and Certification as required by the state of operation.
Strong computer skills, including proficiency in Microsoft Office and data entry.
Experience with Prior Authorization processes.
Registered and Certified Pharmacy Technician credentials (PTCB, NHA).
Experience in retail pharmacy, hospital, or specialty pharmacy settings.
Familiarity with PBM systems and prescription benefits.
Excellent customer service skills.
Experience in call center environments.
This is a professional remote work environment requiring strong WiFi and a dedicated office space with a closed door. Work involves using multiple screens and systems. Must be available Monday through Friday, 8am-8pm in your local timezone, with rotating weekend shifts every 4-6 weeks. Some holiday work is required, with schedules set 3 months in advance. Training will be conducted from 10am-6:30pm EST. Necessary equipment, including a computer, monitor, and headset, will be provided. Flexibility in schedules may be available based on performance and tenure.
This is a Contract to Hire position based out of Nashville, TN.
The pay range for this position is $20.00 - $23.00/hr.
Individual compensation offered for this position within this range will depend on many factors, including qualifications, skills, relevant experience, job knowledge, geographic location, internal equity, and other pertinent job-related factors.
Eligibility requirements apply to some benefits and may depend on your job classification and length of employment.
Benefits are subject to change and may be subject to specific elections, plan, or program terms.
If eligible, the benefits available for this temporary role may include the following:
This is a fully remote position.
This position is anticipated to close on Oct 3, 2026.
Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 20,000 consultants and 5,000 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500. We are proud to be an Engineering News-Record (ENR) Top 500 Design Firm for our engineering design services and a ClearlyRated Best of Staffing winner for both client and talent service.
The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please email actalentaccommodation@actalentservices.com for other accommodation options.
San Francisco Fair Chance Ordinance: Pursuant to the San Francisco Fair Chance Ordinance, for all positions located in the city and county of San Francisco, we will consider for employment qualified applicants with arrest and conviction records.
Massachusetts Lie Detector: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.
Use of Artificial Intelligence (AI): We may use Artificial Intelligence (AI) to support parts of our hiring process, including sourcing, screening, and evaluating candidates. AI helps assess applications and qualifications, but final decisions are made by our hiring team. By applying, you acknowledge and agree that your application may be reviewed using AI tools.