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Pharmacy Technician Specialist

1 month ago

McAllen, Texas, United States Actalent Full time
Job Title:

Pharmacy Technician

Job Description:

As a Pharmacy Technician at Actalent, you will play a crucial role in supporting our clients' pharmacy operations. Your primary responsibility will be to track and triage coverage determination requests, ensuring that they are processed efficiently and effectively.

Key Responsibilities:
  • Review and analyze coverage determination requests to determine if a pharmacist review is required
  • Obtain verbal authorizations and request detailed clinical information from prescribers
  • Approve coverage determination requests based on defined criteria
  • Enter and document coverage determination request decisions into the PBM system and notify providers and/or members
  • Respond to client inquiries regarding authorization approvals and PBM on-line applications
  • Refer coverage determination requests for specialty drugs to delegated vendor or client for processing
  • Contact providers for additional information to facilitate coverage determination reviews
  • Notify physicians, providers, and members of coverage determination request decisions
Requirements:
  • Hard Skills:
    • Reviewing prior authorization requests
    • Making coverage decisions based on plan criteria
    • Documenting coverage determinations
    • Responding to client inquiries
    • Contacting providers for additional information
  • Soft Skills:
    • Attention to detail
    • Effective communication
    • Time management
    • Problem-solving
    • Customer service
About Actalent:

Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation, and speed to market.

We are committed to diversity, equity, and inclusion, and we strive to create a culture that values and respects the contributions of all our employees.