Pharmacy Technician

Overview

Healthcare Staffing Expert at The Judge Group | US Healthcare | Strategic Talent Partner | Passive Hiring Expertise

Job Type: 100% Remote role in New Jersey, Pennsylvania, and Delaware

Summary:

The Pharmacy Technician supports retail pharmacy operations while performing utilization management functions to ensure safe, cost-effective, and medically necessary medication use. This role combines traditional dispensing responsibilities with prior authorization review and managed care coordination.

• Process and dispense prescriptions accurately in compliance with state and federal regulations.
• Review patient profiles and insurance coverage to verify eligibility and benefit plan compliance.
• Perform prior authorization reviews for specialty and high-cost medications using established medical necessity criteria.
• Communicate with prescribers to clarify prescriptions, obtain additional clinical information, and resolve coverage issues.
• Apply critical thinking to assess treatment plans for appropriateness and safety using resources such as Medical Policy, Micromedex, and Care Management guidelines.
• Coordinate with specialty pharmacy vendors for approved authorizations and arrange medication shipment.
• Document all utilization decisions and communications accurately in pharmacy systems and EMR.
• Maintain compliance with state, federal, and accreditation standards for utilization review and pharmacy operations.
• Meet turnaround time and productivity goals for prior authorization and utilization review cases.

• Minimum 2 years of experience in retail pharmacy; prior experience in utilization review, prior authorization, or managed care strongly preferred.
• Knowledge of insurance verification, formulary management, and specialty medication processes.

• Mid-Senior level

• Contract

• Health Care Provider

• Hospitals and Health Care, Public Health, and Health and Human Services