Senior Clinical Ops Technician - UM & PA

Prime Therapeutics; Baton Rouge (LA); On-site; USD 26,000 - 40,000; Full time

Job summary

Prime Therapeutics is seeking a Commercial Senior Technician in Baton Rouge, LA to process formulary exceptions and prior authorizations for delegated utilization management. The role requires attention to detail, strong communication, and collaboration across onshore and offshore teams.

Qualified candidates will have a high school diploma and pharmacy or healthcare experience, with eligibility to work in the United States.

Qualifications

• High school diploma or GED required.
• 2 years pharmacy or healthcare delivery experience required.
• Eligible to work in the United States without visa sponsorship.
• Strong attention to detail and problem-solving skills.
• Excellent communication and teamwork abilities.

Responsibilities

• Serve as a point of contact for internal reviewers and provide guidance on UM processes.
• Respond to escalated calls from the Contact Center and providers with accurate information.
• Enter and update prior authorizations, approvals, or denials in UM systems.
• Monitor and manage inboxes and queues to meet client turnaround requirements.
• Conduct outreach to pharmacies and physician offices to obtain required information for UM requests.
• Provide clinical information to support decision-making and peer reviews.
• Perform other duties as assigned.

Skills

Pharmacy experience

Attention to detail

Communication skills

Problem solving

Education

High school diploma or GED

Tools

Microsoft Office

Job description

Prime Therapeutics is seeking a Commercial Senior Technician in Baton Rouge, LA to process formulary exceptions and prior authorizations for delegated utilization management. The role requires attention to detail, strong communication, and collaboration across onshore and offshore teams.

Qualified candidates will have a high school diploma and pharmacy or healthcare experience, with eligibility to work in the United States.