About this role
Accountabilities
- Serve as an intake point for calls and inquiries from patients, pharmacies, providers, and other healthcare partners, taking ownership of advanced administrative and operational support needs.
- Support clinical pharmacists with medication reconciliation, medication therapy management preparation, disease management activities, medication education, scheduling, and follow-up.
- Conduct medication adherence outreach, auditing, documentation, and reporting activities related to applicable STAR measures.
- Assist with prescription third-party claim rejections by reviewing formulary restrictions, plan limitations, drug utilization review requirements, and available overrides.
- Initiate and complete prior authorization requests and coordinate with health plan representatives and prescribers to resolve medication access issues.
- Support patients with medication assistance programs, formulary exceptions and alternatives, tier reductions, and other affordability solutions.
- Work with internal departments to investigate and resolve member questions or problems, particularly those involving prior authorization and medication access.
- Process selected medication claim updates and lists as requested by clinical pharmacists or providers.
- Maintain current knowledge of medication brand and generic names, medical terminology, and pharmaceutical calculations.
- Participate in scheduled team meetings and provide constructive feedback on workflows, processes, and operational challenges.
- Support additional pharmacy-related activities and initiatives as requested by pharmacy leadership.
Requirements
- Completion of an accredited Pharmacy Technician program.
- Active state pharmacy technician certification and license where required in the state of residence.
- PTCB certification.
- Possession of either a PTCB Medication Therapy Management (MTM) Certification or Medication History Certification, with the ability to obtain the second certification within 60 days of starting.
- At least 3 years of professional experience as a Pharmacy Technician.
- Demonstrated experience handling prior authorizations and resolving medication access issues.
- Strong knowledge of the top 200 commonly prescribed medications, including brand and generic names.
- Experience working with, or the ability to quickly learn, electronic health record systems.
- Strong oral and written communication skills and the ability to interact effectively with patients, providers, pharmacists, health plans, and internal teams.
- Strong problem-solving, organizational, follow-through, and independent decision-making skills.
- Ability to manage sensitive patient information and work effectively in a dedicated, interruption-free home environment.
- Pharmacy Benefit Management experience is preferred.
- Advanced Pharmacy Technician Certification and License (CPhT-ADV) is preferred.
Benefits
- Annual base salary range of $48,300–$65,900 , with actual compensation determined by factors including location, skills, experience, education, certifications, and other job-related qualifications.
- Eligibility for a bonus incentive plan based on company and/or individual performance.
- Fully remote, nationwide work-from-home arrangement.
- Full-time schedule of 40 hours per week , Monday through Friday, generally from 8:00 AM to 5:00 PM local time .
- Medical, dental, and vision coverage.
- 401(k) retirement savings plan.
- Paid time off, company holidays, and personal holidays.
- Paid parental and caregiver leave.
- Short-term and long-term disability coverage.
- Life insurance.
- Additional programs and resources designed to support employee well-being and healthcare needs.
- No regular travel is currently expected, although occasional travel for training or meetings may be required.
- Remote-work setup requires reliable internet service with at least 25 Mbps download and 10 Mbps upload speeds and a dedicated workspace suitable for protecting confidential health information.
How Jobgether works:
We use an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. Our system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company. The final decision and next steps (interviews, assessments) are managed by their internal team.
We appreciate your interest and wish you the best!
Why Apply Through Jobgether?
Data Privacy Notice: By submitting your application, you acknowledge that Jobgether will process your personal data to evaluate your candidacy and share relevant information with the hiring employer. This processing is based on legitimate interest and pre-contractual measures under applicable data protection laws (including GDPR). You may exercise your rights (access, rectification, erasure, objection) at any time.
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