Senior Clinical Operations Technician - Formulary & PA

Prime Therapeutics; Minneapolis (MN); On-site; USD 26,000 - 39,000; Full time

Job summary

Prime Therapeutics is seeking a Commercial Sr Technician to process formulary exceptions, prior authorizations, and brand overrides within delegated utilization management. The role serves as a technical resource for client-specific processes and complex case research.

The Senior Clinical Operations Technician will handle inquiries from internal reviewers, coordinate with providers, and ensure proper documentation for approvals or denials, while maintaining collaboration with onshore and

Qualifications

• 2 years of pharmacy experience or health care delivery experience required.
• Strong communication and problem-solving skills required.
• Ability to learn internal systems and adapt to a dynamic environment.

Responsibilities

• Serve as a liaison for internal reviewers with guidance on complex cases.
• Assist with escalated calls from the Contact Center and providers; document resolutions.
• Enter and update prior authorizations, approvals, or denials in UM systems with accuracy.

Skills

Pharmacy experience

Communication

Attention to detail

Teamwork

Education

High school diploma or GED

Tools

Microsoft Office

Job description

Prime Therapeutics is seeking a Commercial Sr Technician to process formulary exceptions, prior authorizations, and brand overrides within delegated utilization management. The role serves as a technical resource for client-specific processes and complex case research.

The Senior Clinical Operations Technician will handle inquiries from internal reviewers, coordinate with providers, and ensure proper documentation for approvals or denials, while maintaining collaboration with onshore and