Remote Utilization Management Pharmacy Technician - Join Our Dynamic Team!

Remote Full-time
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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