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Pharmacy Technician - Prior Authorization - Work From Home Arizona
About the position
CVS Health is hiring a Pharmacy Technician to process prior authorization requests received by phone, fax, or electronically. The role uses computer resources, existing criteria, and medication guidelines to conduct clinical research supporting prior authorization reviews. Technicians complete approvals and denials that are due to expire, keep timely and accurate documentation, and review potential denial language to ensure NCQA requirements are met. They follow established workflows, policies, and procedures and respond to potentially high volumes of inquiries from providers’ offices, pharmacies, and internal partners, communicating authorization statuses or decisions using various computer resources. The position balances productivity, quality, and timeliness; includes required training, continuing education, and team or departmental meetings; and requires excellent attendance. Successful technicians can pronounce drug names and diagnoses, recognize medical terminology, navigate multiple computer systems, document conversations and decisions, and communicate effectively in writing and verbally. The position is work from home in Arizona. Candidates must have home internet with at least 100 Mbps download speed, a secure home workspace or office, and strong PC skills. Pharmacy prior authorization operations run between 5:00 a.m. and 7:00 p.m., with shifts of eight hours scheduled within those hours; overnight shifts may be available but are not guaranteed. Schedules and hours may change based on company needs. Full-time employees are scheduled for 40 hours per week, including weekends and holidays, and may need to work extended hours. A rotating weekend schedule may be required.
Responsibilities
- Process prior authorization requests received by phone, fax, or electronically, using computer resources, existing criteria, and medication guidelines to conduct supporting clinical research.
- Complete prior authorization approvals and denials that are due to expire.
- Maintain complete, timely, and accurate documentation.
- Review potential prior authorization denial language to ensure NCQA requirements are met.
- Follow prior authorization workflows, policies, and procedures.
- Answer prior authorization inquiry calls from providers’ offices, pharmacies, and internal partners; communicate authorization status or decisions using computer resources.
- Balance productivity, quality, and timeliness of work.
- Participate in training, continuing education, and team or departmental meetings as required.
- Maintain excellent attendance.
Requirements
- Current, in-good-standing national Pharmacy Technician certification and Arizona State Pharmacy Technician license; both must be maintained.
- 1–5+ years of pharmacy prior authorization processing experience.
- Ability to multitask and prioritize work.
- Ability to adjust based on business or department needs.
- Good organizational skills.
- High school diploma or GED.
- Home internet access with a minimum download speed of 100 Mbps.
- A secure workspace or office at home.
- High-level PC skills, including using a mouse and keyboard and accessing and navigating multiple systems and screens.
- Ability to work scheduled shifts that may include weekends and holidays, rotating weekends, and extended hours when necessary.
Nice-to-haves
- Retail or hospital experience.
- Managed care or Medicaid experience.
- AS400 experience.
- Proficiency with computerized resources and software applications.
- Proficiency with Microsoft Excel, Word, and Outlook.
- Knowledge of pharmacy practices and procedures and ability to read and understand clinical information.
- Working knowledge of drug dosage forms, drug strength, and generic and brand-name equivalents.
Benefits
- Medical coverage
- Dental coverage
- Vision coverage
- Paid time off
- Retirement savings options
- Wellness programs
- Other resources, based on eligibility
- Eligible for a CVS Health bonus, commission, or short-term incentive program in addition to base pay
