Remote Pharmacy Technician

Job Description

Pharmacy Technician Prior Authorization (Fully Remote)

Overview

This role supports the Pharmacy Services department by reviewing prior authorization requests for medications covered under government sponsored health plans such as Medicare and Medicaid. You will manage a high volume queue of coverage determination cases, verify member eligibility, assess requests against plan criteria, and ensure timely, accurate decisions. Prior authorization experience and previous remote work experience are highly preferred.

* This position begins as a 6month contract with high likelihood of extension and future potential for permanent hire, contingent on performance.

Key Responsibilities

• Coverage Determination Review Evaluate prior authorization requests submitted by providers to determine if criteria are met for approval.
• Case Triage Track, sort, and route incoming requests; identify when pharmacist review is required.
• Clinical Information Gathering Contact prescribers to obtain missing details needed to complete a determination.
• Decision Processing Approve requests when criteria are clearly met; escalate specialty drug cases to delegated vendors when appropriate.
• Documentation Enter decisions into the PBM system with accurate, complete notes.
• Provider & Member Communication Notify physicians, providers, and members of determination outcomes.
• Client Support Respond to inquiries regarding authorization approvals and PBM online applications.
• Information Follow Up Reach out to providers for additional details needed to finalize reviews.

Schedule & Work Environment

• Training: 10:00am6:30pm EST for the first 5 weeks.
• Post Training Schedule: Set shift between 8:00am8:00pm EST (examples: 85, 96, 107).
• Remote: Fully remote role; prior remote experience strongly preferred.
• Weekends: Rotating weekend coverage every 56 weeks.
• Holidays: Rotating holiday coverage; must be willing to work holidays as needed.

Qualifications

• Prior authorization experience is required.
• 2+ years of pharmacy technician experience in a managed care or prior authorization setting.
• NHA or PTCB certification preferred but not required.
• Previous experience working in a remote environment highly preferred, with strong self management skills.
• Strong communication skills when interacting with providers and members.
• Ability to work efficiently in a fastpaced, high volume queue.
• Comfortable navigating PBM systems and documenting case decisions accurately.

This is a Contract position based out of St. Louis, MO.

The pay range for this position is $20.00 - $23.00/hr.

Individual compensation offered for this position within this range will depend on many factors, including qualifications, skills, relevant experience, job knowledge, geographic location, internal equity, and other pertinent job-related factors.

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)

This is a Contract position based out of St. Louis, MO.

This position is anticipated to close on Oct 24, 2026.

This is a fully remote position.

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