Job Description
We are seeking a dedicated Pharmacy Technician to join a dynamic Pharmacy Services department within a large healthcare insurance company. The role involves reviewing Prior Authorizations for determinations, managing health plans, and handling various types of medications. You will be responsible for approving or denying requests and sending them for a pharmacist's final review. Although the position primarily involves desk work, you may occasionally handle phone calls to and from members for certain plans.
ResponsibilitiesTrack coverage determination requests submitted from providers and determine if a pharmacist review is required.Obtain verbal authorizations and request detailed clinical information from prescribers.Approve coverage determination requests based on defined criteria.Enter and document coverage determination request decisions into the PBM system and notify providers and/or members.Respond to client inquiries regarding authorization approvals and PBM online applications.Refer coverage determination requests for specialty drugs to delegated vendors or clients for processing.Contact providers for additional information to facilitate coverage determination reviews.Notify physicians, providers, and members of coverage determination request decisions.Essential SkillsHigh School diploma or GED.Current Pharmacy Registration and Certification as required by the state of operation.Strong computer skills, including proficiency in Microsoft Office and Outlook.Customer service skills.Data entry proficiency.Experience with Prior Authorization processes.Registered Pharmacy Technician.Additional Skills & QualificationsNationally Certified Technician is a plus and required for some supervisory roles.Experience in call centers, PBM, hospitals, or specialty pharmacies.Certified Pharmacy Technician (CPhT) and National Healthcareer Association (NHA) certifications.Work Environment
This is a professional remote environment where you will work across multiple screens and systems. You must have a strong wifi connection and a designated office space with a closed door. The shift requires flexibility, with availability Monday through Friday between 8 am and 7 pm in your time zone, and includes rotating weekends every 4-6 weeks. Some holidays may be required, with schedules determined long-term. Training is conducted from 10 am to 6:30 pm EST, Monday through Friday. The company will provide necessary equipment, including a computer, monitor, and headset. The role offers the opportunity to transition to a permanent position, with benefits and PTO available upon permanency. Overtime is not required but may be offered occasionally.
Pay and BenefitsThe pay range for this position is $18.00 - $22.00/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 Aug 29, 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.