Pharmacy Technician – Prior Authorizations
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Job Description
CVS Health pharmacy technician processing prior authorizations remotely for Aetna Pharmacy Prior Authorization. Reviewing clinical information, documenting decisions, and handling provider and pharmacy inquiries.
Responsibilities:
- Process prior authorization requests received by phone, fax, or electronically
- Use computer resources, existing criteria, and medication guidelines to perform clinical research supporting prior authorization reviews
- Complete expiring prior authorization approvals and denials
- Maintain complete, timely, and accurate documentation
- Review potential prior authorization denial language for NCQA compliance
- Follow prior authorization workflows, policies, and procedures
- Answer high-volume inquiry calls from provider offices, pharmacies, and internal partners
- Communicate prior authorization status or decisions using computer resources
- Balance productivity, quality, and timeliness
- Participate in required training, continuing education, and team or departmental meetings
Requirements:
- National Pharmacy Technician certification required and must be maintained
- Current, active Arizona or applicable state Pharmacy Technician license in good standing required and must be maintained
- 1–5+ years of Pharmacy Prior Authorization processing experience
- Ability to multitask and prioritize work
- Ability to adjust based on business or department needs
- Good organizational skills
- High-level PC skills, including navigating multiple systems and screens
- Own home internet access with minimum 100 Mbps download speed
- Secure workspace/office in the home
- Ability to work 40 hours per week, including weekends and holidays as scheduled
- Ability to work extended hours when necessary
- Rotating weekend schedule may be required
- Proficiency with computerized resources and software applications
- Proficiency with Microsoft Excel, Word, and Outlook
- Knowledge of pharmacy practices and procedures
- Ability to read and understand clinical information
- Working knowledge of drug dosage forms, drug strengths, and generic/brand equivalents
- High school diploma or GED
- Preferred: retail or hospital experience
- Preferred: managed care or Medicaid experience
- Preferred: AS400 experience
Benefits:
- Medical coverage
- Dental coverage
- Vision coverage
- Paid time off
- Retirement savings options
- Wellness programs
- Other resources supporting physical, emotional, and financial well-being
- CVS Health bonus, commission or short-term incentive program eligibility
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