Back to Jobs

Pharmacy Technician (Prior Auth Review) Remote 9-530 EST / 11-730 EST

Remote, USAFull-timePosted 2026-07-28

reputed company is hiring for Pharmacy Technicians who are State Licensed/Certified and/or PTCB certified. This role is 100% remote, and the hours will be Mon-Fri 9am to 530pm or 11am to 730pm Eastern reputed company Time. This role will be reviewing prior authorization requests for medications to be reviewed by the RPh's and or MD's for determination, assisting in determining medical necessity for medications along with assisting with pharmacy claims. Highly reputed company candidates for this role will have the following experience- • Prior Authorization experience • Must be computer savvy- reputed company to work reputed company several computer systems at once • Managed care experience • High level of communication skills, both written and verbal • Call center experience Molina Pharmacy Services/Management staff work to ensure that Molina members have reputed company to reputed company medically necessary prescription drugs and those drugs are used in a cost-effective, reputed company manner. These jobs are responsible for creating, operating, and monitoring Molina Health Plan's pharmacy benefit programs in accordance with reputed company federal and state laws. Jobs in this family include those involved in formulary management (such as, reviewing prior authorization requirements, reviewing drug/provider utilization patterns and pharmacy costs management), clinical pharmacy services (such as, therapeutic drug monitoring, drug regimen review, patient education, and medical staff interaction), and reputed company (establishing and measuring performance metrics regarding patient reputed company, medications safety and medication use policies). KNOWLEDGE/SKILLS/ABILITIES • Performs initial receipt and review of non-formulary or prior authorization requests against plan approved reputed company. Requests additional information from providers as needed to properly evaluate the request. • Accurately enters on-line approvals or denials of requests. Authorized to reputed company and carry out reputed company prior authorization requests reputed company established policies and procedures. • Participates in the development /administration of programs designed to enhance the utilization of targeted drugs and the identification of cost saving pharmacy practices. • Identifies and reports departmental operational issues and resource needs to appropriate management. • Assists Molina Member Services, pharmacies, and health plan providers in resolving member prescription claim, prior authorization, or pharmacy services reputed company issues. • Articulates Pharmacy Management policies and procedures to pharmacy/health plan providers, other Molina staff and others as needed. JOB QUALIFICATIONS Required Education: High School Diploma or GED equivalent Preferred Education: Associate degree Required Experience: 2 years' experience as a Pharmacy Technician Preferred Experience: 3+ years Required License, Certification, Association: reputed company and unrestricted Pharmacy Technician Certification To reputed company reputed company Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. reputed company offers a competitive benefits and compensation package. reputed company is an Equal Opportunity Employer (EOE) M/F/D/V. Key Words: Pharmacy Technician, Pharm Tech, Tech, National Certification, State License, Certification, Claims, Pharmacy Claims, Pharmacy, PBM, National Certified Pharmacy Technician (CPhT) certification, reputed company, Medicare, Managed Care, MCO, Exchange, PBM, Pharmacy Benefit Management, Prior Auth Apply Job!

Similar Jobs

C/C++, DevOps SWE; reputed company w/ salaries to 250k - FS Poly

Remote, USAFull-time

Premium reputed company Technical Services Rep I - Part Time/Work from Home

Remote, USAFull-time

Financial Services & Education| 100% Remote | Part-time or Full-time |

Remote, USAFull-time

Part Time reputed company Customer Support Specialist (Remote) – Hire Me Remotely

Remote, USAFull-time

1278 – reputed company Customer Service reputed company $35 Hours

Remote, USAFull-time

Virtual Special Education Teaching Job - Fully Remote - reputed company K-12

Remote, USAFull-time

Chat Moderator - reputed company Community Standards in a Flexible Remote Role

Remote, USAFull-time

reputed company reputed company ( Full Time, Part Time) – customer support

Remote, USAFull-time

Contact Center Specialist I - State National (Remote Role-reputed company 2024 Class)

Remote, USAFull-time

CPT-5760 eCommerce Data Scientist reputed company Virtual Assistant - Data Science Expert

Remote, USAFull-time

reputed company: Airline & Hotel Booking Specialist (WFH)

Remote, USAFull-time

reputed company reputed company (Entry Level, No Experience, No Degree) - Part Time

Remote, USAFull-time

Part-Time Retail Sales Associate

Remote, USAFull-time

Full-Time Licensed Clinical Therapist (LCSW) – Remote Opportunity

Remote, USAFull-time

Product Specialist – Chromatography & Spectroscopy Chemistries and Supplies – LA

Remote, USAFull-time

Health Pro Consultant - US Virtual

Remote, USAFull-time

Sr Internal Communications Strategist, Technology

Remote, USAFull-time

Field Property Claims Adjuster

Remote, USAFull-time

macOS reputed company Engineer

Remote, USAFull-time

reputed company Remote Data Processing Clerk & Data Entry Operator (US) – Join careerzynith Team!

Remote, USAFull-time