Remote Utilization Management Tech | PBM & Prior Auth

Judi Health

Denver (CO)

On-site

USD 50,000 - 60,000

Full time

14 days+

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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.