Experience Inc. Jobs

Job Title: Pharmacy Technician

Job Description

We are seeking a diligent and detail-oriented Pharmacy Technician to join our team. The role involves reviewing Prior Authorizations, approving or denying them, and sending them to a Pharmacist for final review. You will handle all health plans and types of medications, and occasionally manage inbound calls from members. This position is part of a large healthcare insurance company, offering a professional remote environment with opportunities for long-term career growth.

Responsibilities

• Track coverage determination requests submitted from providers and 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 online 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.

Essential Skills

• Registered Pharmacy Technician in the state of residence.

• Nationally Certified Technician (CPhT).

• High School Diploma or GED.

• Strong computer skills, including proficiency with Microsoft Office and Outlook.

• Basic computer skills.

• Experience with prior authorization processes.

Additional Skills & Qualifications

• Customer service skills.

• Experience in call center, PBM, hospital, or specialty pharmacy settings.

• Strong organizational and multitasking abilities.

• Ability to handle inbound calls effectively.

Work Environment

This is a remote position requiring a professional home office setup with strong WiFi and a closed-door workspace.

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.

Diversity, Equity & Inclusion

At Actalent, diversity and inclusion are a bridge towards the equity and success of our people. DE&I are embedded into our culture through:

• Hiring diverse talent

• Maintaining an inclusive environment through persistent self-reflection

• Building a culture of care, engagement, and recognition with clear outcomes

• Ensuring growth opportunities for our people

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 process due to a disability, please email actalentaccommodation@actalentservices.com (%20actalentaccommodation@actalentservices.com) for other accommodation options.