Job Description:
As a Pharmacy Technician, you will track and triage coverage determination requests submitted from providers and determine if a pharmacist review is required. You will also obtain verbal authorizations and request detailed clinical information from prescribers, approve coverage determination requests based on defined criteria, and enter and document coverage determination request decisions into the PBM system. Additionally, you will notify providers and/or members, respond to client inquiries regarding authorization approvals and PBM online applications, and refer coverage determination requests for specialty drugs to delegated vendors or clients for processing. You will also contact providers for additional information to facilitate coverage determination reviews and notify physicians, providers, and members of coverage determination request decisions.
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/or 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.Notify physicians, providers, and members of coverage determination request decisions.Essential SkillsPharmacy technician certification.Experience in pharmacy (retail, hospital, or mail order).Additional Skills & QualificationsHigh school diploma or equivalent.1+ years of retail, hospital, or mail order pharmacy experience.Current state Pharmacy Technician license and National Certification from Pharmacy Technician Certification Board preferred.Work Environment
You will work in a dynamic environment, utilizing the PBM system and other relevant technologies to manage coverage determination requests. The role may involve regular communication with providers and clients to ensure proper authorization and processing of requests.
If you're interested, APPLY NOW and EMAIL your updated resume to sstaso @ actalentservices.com!Pay and Benefits
The pay range for this position is $18.00 - $19.00/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 Mar 18, 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.
Diversity, Equity & InclusionAt Actalent, diversity and inclusion are a bridge towards the equity and success of our people. DE&I are embedded into our culture through:
Hiring diverse talent Maintaining an inclusive environment through persistent self-reflection Building a culture of care, engagement, and recognition with clear outcomes Ensuring growth opportunities for our peopleThe 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 process due to a disability, please email actalentaccommodation@actalentservices.com for other accommodation options.