Pharmacy Prior Authorization Technician - Diabetes and Endocrinology

Description

Professional - Clinical
Req #: 68440

(Eligible for $3,000 Sign on Bonus paid out in three installments, prorated for Part Time) Current Maine Health employees not eligible for the sign on bonus. Must be separated from Maine Health system for 6 months to be eligible.

Summary
:

The Pharmacy Prior Authorization Technician is responsible for coordinating and processing prior authorizations (PAs) for prescription medications to ensure timely patient access to treatment. Working closely with providers, pharmacists, payers, and patients, the technician utilizes the EHR and payer portals to facilitate and document the PA process.

This role is key to supporting the clinical team in minimizing treatment delays and improving medication access. The role will initially be focused on prior authorizations for our Maine Health Diabetes and Endocrinology practices, but this could expand.

Key Responsibilities
:

* Review medication orders (especially specialty medications) needing prior authorization.

* Initiate and complete prior authorization requests through electronic portals (e.g., Cover My Meds , Surescripts, payer websites).

* Communicate with insurance companies to gather coverage requirements and status updates.

* Collaborate with providers and pharmacists to obtain necessary clinical documentation for PA submissions.

* Document PA status, approvals, denials, and follow-ups within Epic using Smart Phrases and encounters.

* Notify providers of PA outcomes and assist with alternative medication strategies when necessary.

* Track and manage open prior authorizations to ensure timely resolution and refill coordination.

* Support clinic staff and patients by providing status updates or coverage information as allowed.

* Maintain up-to-date knowledge of payer formulary changes and authorization requirements.

* Participate in continuous quality improvement and workflow optimization efforts.

Required Minimum Knowledge, Skills, and Abilities (KSAs)

Education: High school diploma or equivalent required.

License/Certifications: Current or eligible for applicable state(s) license as a Pharmacy Technician. CPhT certification is required.

Experience: One year of experience as a licensed pharmacy technician.

Additional Skills/Requirements

Required:

N/A

Additional Skills/Requirements Preferred: N/A

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Additional Information

With a career at any of the Maine Health locations across Maine and New Hampshire, you'll be working with health care professionals that truly value the people around them - both within the walls of the organization and the communities that surround it.

We offer benefits that support an individual's needs for today and flexibility to plan for tomorrow - programs such as paid parental leave, a flexible work policy, student loan assistance, training and education, along with well-being resources for you and your family.

Maine Health remains focused on investing in our care team and developing an inclusive environment where you can thrive and feel supported to realize your full potential. If you're looking to build a career in a place where people help one another deliver best-in-class care, apply today.

If you have questions about this role, please contact brandon.drinkwater