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Job Title: Certified Pharmacy Technician - Prior AuthorizationJob Description

The Certified Pharmacy Technician for Prior Authorization will be responsible for processing coverage determinations, including prior authorization and exception requests, to the Plan formulary. This role involves receiving, researching, documenting, and processing these determinations promptly, as required by regulatory standards. Additionally, this position requires effective communication of decisions with providers, members, and internal staff.

Responsibilities

+ Receive, review, process, and respond to coverage determinations to the Plan formulary in accordance with departmental guidelines and federal regulations.

+ Provide support to internal and external customers, serving as a representative for the department.

+ Maintain coverage determination policies and procedures and assist with policy and procedure education for customers.

+ Manage responsibilities that may require evening and weekend work, as well as overtime, to meet CMS requirements.

Essential Skills

+ 3-5 years of experience as a Certified Pharmacy Technician.

+ Experience with prior authorization.

+ Current Pharmacy Technician License in good standing with the Alabama State Board of Pharmacy.

+ Certified Pharmacy Technician (CPhT) from the Pharmacy Technician Certification Board or the National Healthcare Association.

+ Excellent customer service skills in written and verbal communication.

+ Basic computer skills.

+ Ability to work overtime and share responsibilities during after-hours, holidays, inclement weather, and weekends.

Additional Skills & Qualifications

+ Bachelor’s Degree or equivalent work experience.

+ Customer service or call center experience.

+ Experience in a physician's office.

+ Experience with Health Plan or PBM.

Work Environment

The role offers remote work opportunities, transitioning to mostly remote after successful training with occasional in-office days. The office environment includes working in a cubicle within a small, busy department. The dress code is business casual.

Pay and Benefits

The pay range for this position is $20.00 - $22.00/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 hybrid position in Birmingham,AL.

Application Deadline

This position is anticipated to close on Jun 11, 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 [email protected] (%[email protected]) for other accommodation options.