Prior Authorization Pharmacy Technician (Seasonal)

This is a 6 month contract position where you will assist members, providers, pharmacies, and the internal SmithRx teams to navigate complexities of prescriptions to guide timely coverage of clinically appropriate, cost effective medication therapy in accordance with plan benefit design and clinical criteria for coverage. This may involve coordination of clinical review cases, checking coverage and plan rules, verification of submitted information, pharmacy and provider outreach, review of prior authorization requests within established protocols, and assisting to triage and troubleshoot questions and escalations. At SmithRx, we design customized benefit plans for our customers and you are at the forefront of helping navigate and execute drug access.

High School diploma or GED or equivalent work experience

Active Pharmacy Technician license required

2-4 years of experience as a Pharmacy Technician

2+ years of experience in prior authorization review (specifically working on the approval side at a PBM or health plan) required

Proficiency in Mac, MS Office, G-Suite required

Critical thinking to navigate complex customized benefit plans to make sound clinical decisions

Active listening, conversational speaking skills, with a high degree of empathy

Self-starter with ability to multitask, prioritize and manage time effectively

Ability to communicate clearly, present complex information to members, clients, pharmacies, providers, and other teams internally

Ability to work accurately within protocols and follow appropriate escalation pathways for unique situations or where clarification is needed.

Zone A includes the following locations:

San Francisco Bay Area - California

Metro New York City - Connecticut, New Jersey, New York and Pennsylvania

Zone B includes the following locations:

California - outside of San Francisco Bay Area

Metro Denver / Boulder - Colorado

Metro District of Columbia - District of Columbia, Maryland, Virginia and West Virginia

Metro Boston / Cambridge - Massachusetts and New Hampshire

Metro Austin - Texas

Metro Seattle - Washington

Zone C includes all other locations not listed above, including:

Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Mexico, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Rhode Island, South Carolina, South Dakota, Tennessee, Utah, Vermont, Wisconsin, Wyoming

Non metro Colorado, Connecticut, Maryland, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Texas, Virginia, Washington, and West Virginia