Remote Utilization Management Tech | PBM & Prior Auth

Judi Health; Denver (CO); On-site; USD 50,000 - 60,000; Full time

Job summary

Judi Health is seeking a remote Pharmacy Technician to support prior authorization processes for a national client base. You will validate information, gather clinical details, and coordinate with prescribers to support pharmacist determinations.

Ideal candidates have 2+ years of PBM or clinical pharmacy experience, a CPhT license, and excellent communication skills. The role offers a remote US salary range and opportunities to contribute in a fast-paced startup environment.

Qualifications

• 2+ years of pharmacy technician experience in PBM/health plan or clinical setting.
• Experience handling prior authorization requests and understanding requirements.
• National Certified Pharmacy Technician (CPhT) license required.

Responsibilities

• Prepare prior authorization requests by validating prescriber and member information, level of review, and guidelines.
• Make outbound calls to providers to obtain additional clinical information for pharmacist review.
• Proactively obtain clinical information to address guidelines for pharmacist review.
• Review and analyze pharmacy claims data for proactive outreach and intervention.
• Triage calls from members, pharmacy staff, and providers with clinical questions.
• Communicate issues and resolutions to members, staff, providers, and stakeholders.
• Follow SOPs and HIPAA guidelines and company policies.
• Ensure customer satisfaction with professional, fast-paced service in a startup environment.

Skills

Pharmacy technician

Prior authorization

Communication

Remote work

Education

CPhT license

High school diploma

Associate/Bachelor preferred

Tools

PBM software

Job description

Judi Health is seeking a remote Pharmacy Technician to support prior authorization processes for a national client base. You will validate information, gather clinical details, and coordinate with prescribers to support pharmacist determinations.

Ideal candidates have 2+ years of PBM or clinical pharmacy experience, a CPhT license, and excellent communication skills. The role offers a remote US salary range and opportunities to contribute in a fast-paced startup environment.