REMOTE PHARMACY TECHNICIAN – PRIOR AUTHORIZATION (PTCB/NHA)

DG GLASS - Desde 2001 conectando negocios confiaveis.; Nashville (TN); Remote; USD 25,000 - 36,000; Part time

Job summary

DG GLASS - Desde 2001 conectando negocios confiaveis. is seeking an Utilization Support Technician for a fully remote contract role starting November 2026.

The position involves managing utilization management requests, coordinating with the UM team and specialty pharmacy partners, and ensuring regulatory privacy compliance. The ideal candidate will have 1–2 years as a pharmacy technician in PBM or health-plan settings, hold a CPhT, and demonstrate strong communication and problem-solving skills

Qualifications

• 1-2 years as a pharmacy technician in PBM or health plan setting.
• 1-2 years in mail order or specialty pharmacy is acceptable.
• Active Certified Pharmacy Technician (CPhT) credential.
• Strong attention to detail and patient-focused service.

Responsibilities

• Support utilization management requests for coverage and enter authorizations.
• Coordinate with UM team, specialty pharmacy partner, and patient programs.
• Liaise with Pharmacy technicians, Pharmacists, and Medical Directors on UM activities.
• Make outbound calls to provider offices to obtain missing clinical information.
• Ensure cases meet State/Federal guidelines and turnaround times.
• Participate in quality reviews and inter-rater reliability processes.
• Handle provider calls regarding UM status inquiries.
• Maintain regulatory and privacy standards.

Skills

Pharmacy technician

PBM knowledge

Call center experience

Detail oriented

CPhT certified

Education

High school diploma

Job description

Location: Fully remote

#IND123

Utilization Support Technician

Location: Fully remote

Cannot reside in the following states: CA, DE, MA, MI, NJ, NY, OR, WA, CO, IL

Pay: $22.00 per hour

Start date: November 2026

Type: Contract until April 2027, can go perm based on Performance and Attendance

Shifts: You will be assigned a shift:

• M-F, 10:00 AM - 06:30 PM EST
• M-F, 11:30 AM - 08:00 PM EST
• Training shift: M-F, 9:00 AM to 5:00 PM EST

Job Description

• Support all lines of business via facilitating the process for utilization management requests for coverage, entering authorizations into the claims platform, and facilitating member and provider communications
• Provides support to members enrolled in specialty management programs, including coordinating any needed prior authorization with the UM team, the fulfillment of the prescription with the specialty pharmacy partner, enrollment in patient assistance programs, and billing questions.
• Coordinate with Pharmacy technicians, Pharmacists, and/or Medical Directors on UM activities
• Make outbound calls to provider offices to obtain clinical information missing from UM submitted cases
• Ensure cases are reviewed in accordance with State and/or Federal guidelines including turnaround time requirements
• Participate in the quality review and inter-rater reliability processes
• Provider call center: answer prescriber inquiries about the status UM requests
• Ensures regulatory and privacy standards are consistently met.

Required

• 1-2 years experience in a pharmacy technician role within a PBM, pharmacy department of a health plan, or similar managed care setting.
• Or 1-2 years experience working in a mail order or specialty pharmacy
• Active Certified Pharmacy Technician (CPhT)
• Detail-oriented, critical thinker, empathetic, ability to dig deep in understanding an issue to get to true root cause and resolution, desire to improve a patient’s healthcare experience and provide concierge level service.
• Knowledge of pharmacy claims adjudication and benefit designs/terminology, call center experience, ability to multi-task and prioritize work, ability to work independently.
• High school diploma or equivalent
• Background check required