Remote Senior CPhT - PBM Expert

Gainwell Technologies; Texas; Remote; USD 34,000 - 48,000; Full time

Job summary

Gainwell Technologies is seeking a Senior Certified Pharmacy Technician to join its PBM Clinical and Technical Call Center. This 100% remote role serves members, providers, and pharmacy teams with complex benefit questions and medication access needs, drawing on advanced pharmacy knowledge and PBM experience.

You will resolve complex inquiries, support prior authorizations, share expertise with teammates, and help ensure accurate, timely service across phone, fax, email, and web portals while

Qualifications

• Active and current CPhT credential.
• Minimum of 2 years call center experience in healthcare or PBM.
• PBM experience including formulary management and claims adjudication.
• Strong knowledge of pharmacy claims processing and rejection resolution.
• Excellent communication, computer skills, and multi-system proficiency.
• Leadership experience or PBM call center exposure preferred.

Responsibilities

• Provide advanced support to members, prescribers, and pharmacy providers via phone, fax, email, and web channels.
• Research and resolve complex PBM inquiries, including claims, rejections, formulary questions, and access issues.
• Coordinate prior authorization processes and ensure timely handling within guidelines.
• Act as a subject matter expert and assist with escalations, training, and onboarding.
• Contribute to quality and process improvement while meeting standards.

Skills

CPhT credential

Call center experience

PBM experience

Pharmacy claims processing

Formulary knowledge

Communication skills

Job description

Gainwell Technologies is seeking a Senior Certified Pharmacy Technician to join its PBM Clinical and Technical Call Center. This 100% remote role serves members, providers, and pharmacy teams with complex benefit questions and medication access needs, drawing on advanced pharmacy knowledge and PBM experience.

You will resolve complex inquiries, support prior authorizations, share expertise with teammates, and help ensure accurate, timely service across phone, fax, email, and web portals while