Job Description
We are seeking a dedicated Pharmacy Technician 1 to efficiently manage coverage determination requests submitted by providers. This role involves tracking and triaging requests, obtaining verbal authorizations, and requesting detailed clinical information from prescribers. You will be responsible for approving coverage determination requests based on defined criteria and entering the decision into the PBM system, while notifying providers and members accordingly. Additionally, you will respond to client inquiries regarding authorization approvals and the PBM online application.
ResponsibilitiesTrack and triage coverage determination requests submitted from providers.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.Notify providers and members of coverage determination request decisions.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.Essential SkillsCurrent state's Pharmacy Technician license.National Certification from Pharmacy Technician Certification Board (CPhT).1+ years of experience in retail, hospital, or mail order pharmacy.Work Environment
This role requires working with pharmacy support systems and involves prior authorization processes. The position demands a detail-oriented professional capable of handling multiple tasks efficiently. The work environment is dynamic and may require interaction with various healthcare providers and clients through digital platforms.
Pay and Benefits
The pay range for this position is $19.00 - $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 Jun 19, 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.