Pharmacy Technician

We are seeking a dedicated Pharmacy Technician - Prior Authorization Specialist to join our team. This role involves managing coverage determination requests and facilitating communication between providers, pharmacists, and members. You will play a crucial role in ensuring that authorizations are processed efficiently and accurately.

Responsibilities:

• Track and triage coverage determination requests submitted by providers.
• Determine if a pharmacist review is required for submitted requests.
• 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.
• Notify providers and/or members of decision outcomes.
• Respond to client inquiries regarding authorization approvals and PBM online applications.
• Refer coverage determination requests for specialty drugs to delegated vendors or clients for processing.
• Contact providers for additional information to facilitate coverage determination reviews.
• Notify physicians, providers, and members of coverage determination request decisions.

Essential Skills:

• Prior authorization experience.
• Data entry proficiency.
• Pharmacy experience.
• Customer service skills.
• Pharmacy technician license.
• Proficient computer skills.

Additional Skills & Qualifications:

• Experience with Microsoft applications.
• Managed care knowledge.
• Familiarity with Medicare/Medicaid.
• Experience with remote work setups.

Work Environment:

This position offers a 100% remote work environment. Start times can range from 8 AM to 10 AM EST, with an hour lunch break. The training schedule is from 10 AM to 6:30 PM EST, Monday through Friday, with a 30-minute unpaid lunch. Rotating weekends are required every 4-6 weeks.

Job Type & Location:

This is a Contract to Hire position based out of Springfield, MO. Pay range for this position is $18.00 - $20.00/hr. 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)

Workplace Type:

This is a fully remote position.

Application Deadline:

This position is anticipated to close on Dec 2, 2025.

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. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500. The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law. If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing due to a disability, please email acta Lentaccommodation@actalentservices.com for other accommodation options.