Job Description
Pharmacy technicians will operate in an EST timezone, primarily reviewing Prior Authorizations for coverage determination within a Pharmacy Services department associated with a large healthcare insurance company. They will be responsible for approving or denying requests and forwarding them to a pharmacist for final review. This role involves handling all health plans and types of medications with minimal phone interaction, mostly outbound.
ResponsibilitiesTrack coverage determination requests and obtain verbal authorizations.Approve requests based on criteria and enter decisions into the PBM system.Notify providers and members of decisions.Respond to client inquiries and refer requests for specialty drugs.Contact providers for additional information and notify stakeholders of decision outcomes.Obtain verbal authorizations and request detailed clinical information from prescribers.Assist with inbound and/or outbound patient or physician calls if needed.Essential SkillsHigh School diploma or equivalent.Current Pharmacy Registration and Certification as required by the state of operation.Strong computer skills, including Microsoft Office and Outlook.Experience with data entry and customer service.Registered Pharmacy Technician and Certified Pharmacy Technician credentials.Prior authorization experience.Additional Skills & QualificationsExperience in retail pharmacy, call center, hospital, or specialty pharmacy settings.Knowledge of Medicare and Medicaid.Experience with prescription benefits management.National certification (e.g., PTCB, NHA).Work Environment
This is a professional remote environment where you will work across multiple screens and systems. You must have a strong Wi-Fi connection and a dedicated office space with a closed door. The schedule requires availability Monday through Friday, 8 AM to 8 PM in your local time zone, with rotating weekends every 4-6 weeks and some holidays. Holiday schedules will be bid for. Training will occur from 10 AM to 6:30 PM EST. After training, regular shifts are assigned with schedules sent three months in advance. The company provides necessary equipment, including a computer, monitor, and headset.
Pay and BenefitsThe pay range for this position is $18.00 - $20.00/hr.
Eligibility requirements apply to some benefits and may depend on your job
classification and length of employment. Benefits are subject to change and may be
subject to specific elections, plan, or program terms. If eligible, the benefits
available for this temporary role may include the following:
• Medical, dental & vision
• Critical Illness, Accident, and Hospital
• 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available
• Life Insurance (Voluntary Life & AD&D for the employee and dependents)
• Short and long-term disability
• Health Spending Account (HSA)
• Transportation benefits
• Employee Assistance Program
• Time Off/Leave (PTO, Vacation or Sick Leave)
Workplace Type
This is a fully remote position.
Application Deadline
This position is anticipated to close on Jul 26, 2025.
About Actalent
Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500.
The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing due to a disability, please email actalentaccommodation@actalentservices.com for other accommodation options.