Remote Pharmacy Technician, Utilization Management

Archimedes; United States; Remote; USD 27,552,000 - 41,328,000; Full time

Benefits offered by this job

Health insurance

Dental insurance

Vision insurance

Paid time off

Parental leave

Paid holidays

401K match

Adoption assistance

Flexible Spending Account

Educational assistance

Professional membership assistance

Referral bonus

Job summary

Archimedes is seeking a Pharmacy Technician, Utilization Management to join our team. You will support first-level reviews of specialty medication prior authorizations and manage high-cost cases in alignment with clinical policies.

You will coordinate with physicians, nurses, and pharmacists to obtain missing documentation and provide drug cost information for specialty and traditional medications, while maintaining timely communication with prescribers.

Qualifications

• High school diploma or GED required.
• Licensed Pharmacy Technician with valid license.
• Experience in Pharmacy, Hospital, or Managed Care preferred.
• Ability to adhere to compliance program objectives.

Responsibilities

• Develop and deliver follow up messages to physicians and members related to prior authorization and high-cost case management case documentation.
• Manage and act as primary point of contact for all high-cost management and retroactive drug utilization cases, including outbound physician notification and inbound case documentation.
• Manage queues for pharmacy technician work related to prior authorization, high-cost cases, claims editing and clinical policy processes.
• Perform prior authorization case management related to administrative denial and low-clinical acuity cases as identified by policies and guidelines.
• Participate in special projects, process improvement initiatives, and cross-functional assignments.
• Manage assigned ticket work by monitoring requests, researching issues, documenting actions, and ensuring timely resolution or escalation.
• Contact prescriber offices to request missing clinical information and supporting documentation needed to complete case reviews.
• Document outreach attempts and responses accurately within applicable systems.
• Other duties as assigned.

Skills

Licensed Pharmacy Technician

Prior authorization

Communication

Team collaboration

Education

High school diploma or GED

Job description

Archimedes is seeking a Pharmacy Technician, Utilization Management to join our team. You will support first-level reviews of specialty medication prior authorizations and manage high-cost cases in alignment with clinical policies.

You will coordinate with physicians, nurses, and pharmacists to obtain missing documentation and provide drug cost information for specialty and traditional medications, while maintaining timely communication with prescribers.