Pharmacy Technician, Prior Authorization in New York at Jobgether
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Job Description
This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Pharmacy Technician, Prior Authorization based in the United States.
This fully remote role supports medical management operations within a health plan focused on improving care for older adults.
You’ll play an important role in reviewing and coordinating pharmacy prior authorization requests and supporting timely clinical decisions.
The position combines pharmacy knowledge, provider communication, member support, and detailed administrative work.
You’ll collaborate closely with pharmacists, physicians, providers, members, and clinical partners across multiple workflows.
The environment is fast-paced and dynamic, requiring strong organization, adaptability, and attention to detail.
Your work will directly contribute to accurate benefit administration and a smoother healthcare experience for members.
This is an excellent opportunity for an experienced pharmacy technician seeking meaningful, healthcare-focused work from home.
- Review and process prior authorization requests in accordance with established policies, procedures, and decision trees, ensuring accurate and timely handling.
- Triage and enter incoming authorization requests from provider offices and coordinate the information required for clinical review.
- Apply preferred product strategies and collaborate with providers to support appropriate utilization of Part B medication benefits.
- Contact hospitals and provider offices to obtain necessary clinical documentation and follow up on outstanding information.
- Communicate clinical decisions to provider groups and members while addressing questions and concerns regarding alternative treatment options.
- Provide operational support across medical management workflows, enabling pharmacists and physicians to make efficient, high-quality decisions.
- Serve as a key point of contact for internal and external stakeholders and provide workflow support to clinical partners.
- Interpret plan benefits and process specialty pharmacy overrides to support accurate claim adjudication.
- Manage multiple priorities in a fast-moving environment while maintaining accuracy, accountability, and high service standards.
- Work the assigned schedule of 11:30 AM–8:00 PM ET and participate in a mandatory weekend rotation.
- Hold an active Nationally Certified Pharmacy Technician (CPhT) certification with at least 3 years of professional pharmacy technician experience.
- Demonstrated experience supporting Medicare Part B operations, such as pharmacy help desk functions, utilization management, or prior authorization.
- Experience working with Medicare populations and a strong interest in supporting older adults.
- Prior utilization management experience is preferred.
- Strong proficiency with technology and digital collaboration tools, including Gmail/G Suite and multiple software systems.
- Exceptional organization and attention to detail, with the ability to manage several tasks and changing priorities simultaneously.
- Strong written and verbal communication skills, particularly when working with providers, members, partners, and internal teams.
- Comfortable operating in a fast-paced environment where priorities can shift quickly and unexpected issues require practical problem-solving.
- Demonstrated ability to identify process improvements, take ownership of responsibilities, and remain calm and dependable under pressure.
- A service-oriented, collaborative mindset with the flexibility and agility to adapt throughout the workday.
- Base pay: $20.90–$26.25 per hour, with actual compensation based on qualifications, experience, skills, education, certifications, and location.
- Employer-sponsored medical, dental, and vision coverage, with low or no employee premiums depending on the plan.
- Generous paid time off.
- $100 monthly mobile or internet stipend.
- Stock options available to all employees.
- Bonus eligibility for eligible roles.
- Parental leave program.
- 401(k) program.
- Fully remote/work-from-home position within the United States.
- Opportunity to contribute to healthcare services supporting an aging population.
- Total Rewards package applies to eligible full-time employees.