Job Description

Job Description

Job Description

Fully Remote Certified Pharmacy Technician

Job Description

The Certified Pharmacy Technician evaluates and authorizes Medicaid prior authorization pharmacy requests in a high-volume call center environment. This role focuses on determining the clinical appropriateness of medications using established criteria, clearly documenting outcomes, and communicating decisions to healthcare professionals. The technician works primarily by phone and fax, follows detailed step-by-step guidelines, and escalates complex cases to a pharmacist when necessary. This is a fully remote position with structured training and the opportunity for contract extension or conversion after the initial term.

Responsibilities

• Evaluate and authorize Medicaid prior authorization pharmacy requests received by telephone using established clinical criteria.
• Determine the appropriateness of medications based on client clinical guidelines and coverage rules.
• Communicate prior authorization decisions to physicians, physician office staff, medical management staff, and pharmacists in a clear and professional manner.
• Document all prior authorization outcomes accurately and completely in the pharmacy system.
• Explain prior authorization criteria, pharmacy benefit coverage, and formulary alternatives to prescribers and other healthcare professionals.
• Escalate requests to a pharmacist when a case requires extensive clinical review or when a denial is indicated, following clearly written step-by-step procedures.
• Document physician and client inquiries and grievances and provide timely verbal or written results to clients, prescribers, providers, and management.
• Work in the fax queue as needed, clinically reviewing coverage determinations for medications received via fax with strong attention to detail.
• Communicate fax-based decisions to physicians, physician office staff, medical management staff, and pharmacists within established service level agreement (SLA) timelines.
• Efficiently multitask and monitor several queues and assignments, including fax work, pending queues, oral notifications, and failed faxes.
• Adapt to changing team requirements and business needs, including shifts in workload and queue priorities.
• Maintain a high level of accuracy, professionalism, and customer service in all interactions, whether by phone, fax, or electronic systems.
• Navigate multiple computer systems and applications simultaneously to research, process, and document prior authorization requests.
• Participate fully in classroom-style training and apply learned procedures, policies, and systems to daily work.
• Work assigned shifts consistently, including potential weekends and holidays, and comply with overtime requirements during peak seasons when needed.

Essential Skills

• High school diploma or GED.
• Active state pharmacy technician registration or license.
• National pharmacy technician certification (PTCB or NHA).
• At least 1 year of experience in a retail or call center pharmacy environment (3+ years preferred).
• Experience with prior authorization processes in a pharmacy or related setting.
• Proficient data entry skills with a high level of accuracy.
• Strong written and verbal communication skills for interacting with healthcare professionals and internal teams.
• Excellent attention to detail and organizational skills.
• Ability to comfortably navigate and work within multiple computer systems and applications at the same time.
• Ability to work independently and maintain productivity in a fast-paced, remote environment.
• Customer service orientation with the ability to handle inquiries and grievances professionally.

Work Environment

This is a 100% remote position, open to candidates located in any U.S. state except California, Hawaii, and Puerto Rico. The role operates within a call center and fax-based environment, where you will handle prior authorization requests via phone and electronic fax systems. Standard schedules consist of 8-hour shifts between 6:00 a.m. and 9:00 p.m. CST, Monday through Sunday. You will be assigned a specific shift; some shifts include weekends and some do not. Overtime may be required during peak season, typically from November through May, depending on business needs. Holidays may also be scheduled workdays based on operational requirements.

You will receive approximately 68 weeks of classroom-style training, Monday through Friday from 8:30 a.m. to 5:00 p.m. CST, led by dedicated trainers. The position begins as a 1-year contract, with the intention to convert or extend the contract after the initial term, subject to business needs and performance. Around 80 hours (2 weeks) of unpaid time off is available during the 1-year contract; to guarantee approval, all planned time off must be disclosed prior to interviewing, and any additional requests are subject to business needs and may not be approved.

The organization provides all necessary equipment for remote work, including a laptop, mouse and keyboard, headset, second monitor, and privacy screen. You will work from a home office or similarly quiet, secure space that supports confidential handling of protected health information and consistent internet connectivity.

This is a Contract position based out of Houston, TX.

The pay range for this position is $22.00 - $22.00/hr.

Individual compensation offered for this position within this range will depend on many factors, including qualifications, skills, relevant experience, job knowledge, geographic location, internal equity, and other pertinent job-related factors.

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)

This is a Contract position based out of Houston, TX.

This position is anticipated to close on Oct 30, 2026.

This is a fully remote position.

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 20,000 consultants and 5,000 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500. We are proud to be an Engineering News-Record (ENR) Top 500 Design Firm for our engineering design services and a ClearlyRated Best of Staffing® winner for both client and talent service.

The company is an equal opportunity employer and will consider all applications withoutregard to race, sex, age, color, religion, national origin, veteran status, disability,sexual orientation, gender identity, genetic information or any characteristic protectedby law.

If you would like to request a reasonable accommodation, such as the modification oradjustment of the job application process or interviewing process due to a disability,please email actalentaccommodation@actalentservices.com for other accommodation options.

San Francisco Fair Chance Ordinance: Pursuant to the San Francisco Fair Chance Ordinance, for all positions located in thecity and county of San Francisco, we will consider for employment qualified applicantswith arrest and conviction records.

Massachusetts Lie Detector: It is unlawful in Massachusetts to require or administer a lie detector test as acondition of employment or continued employment. An employer who violates this lawshall be subject to criminal penalties and civil liability.

Use of Artificial Intelligence (AI): We may use Artificial Intelligence (AI) to support parts of our hiring process,including sourcing, screening, and evaluating candidates. AI helps assess applicationsand qualifications, but final decisions are made by our hiring team. By applying, youacknowledge and agree that your application may be reviewed using AI tools.

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