Job Highlights:
- Position: Remote Utilization Management Pharmacy Technician
- Start Date: Immediate openings available
- Location: Remote work arrangement
- Compensation: Competitive salary range ($41,101 - $62,400) and comprehensive benefits package
- Company: Workwarp, a leading healthcare organization
We are seeking a highly skilled and motivated Remote Utilization Management Pharmacy Technician to join our team. As a key member of our multidisciplinary team, you will play a critical role in reviewing prior authorization requests, making approval decisions, and providing exceptional customer service to our members and providers.
Job Summary:
The Remote Utilization Management Pharmacy Technician is responsible for reviewing prior authorization requests for medications requested under the medical benefit, assessing clinical information for appropriateness, and making approval decisions based on predetermined clinical criteria. This role requires strong communication and customer service skills, as well as the ability to work effectively in a remote environment.
Key Responsibilities:
- Review prior authorization requests and units for medications requested under the medical benefit
- Assess provider-submitted clinical information for clinical appropriateness based on predetermined clinical criteria
- Send notification to members and providers of authorization decisions via telephone, fax, or mail
- Ensure prior authorization reviews are conducted within timeframes set forth by CMS and/or NYSDOH
- Establish and maintain strong relationships with provider offices via telephonic communication
- Maintain confidentiality and compliance with federal law and HIPAA regulations
Requirements:
- High School Diploma or GED from an accredited institution
- Nationally certified Pharmacy Technician in good standing (i.e., PTCB, NHA) or registered or licensed Pharmacy Technician in good standing
- Experience conducting prior authorization reviews
- Excellent written, verbal, and telephonic communication skills in English
Preferred Qualifications:
- Strong written and verbal communication skills in Chinese, Spanish, or Russian
- Demonstrated critical thinking and problem-solving skills
- Team player with a passion for learning and interest in growing skills in a dynamic environment
- Knowledge of specialty pharmaceuticals and billing practices in the medical benefit
- Experience with TruCare Care Management Platform
What We Offer:
- Competitive salary range ($41,101 - $62,400)
- Comprehensive benefits package, including medical, dental, and vision coverage
- Incentive and recognition programs
- Life insurance and 401k contributions
- Opportunities for professional growth and development
We Are an Equal Opportunity Employer:
We are committed to diversity and inclusion, and welcome applications from qualified candidates of all backgrounds. Apply today to join our dynamic team!
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