Pharmacy Technician

Overview Healthcare Staffing Expert at The Judge Group | US Healthcare | Strategic Talent Partner | Passive Hiring Expertise Job Type: 100% Remote role in New Jersey, Pennsylvania, and Delaware Summary: The Pharmacy Technician supports retail pharmacy operations while performing utilization management functions to ensure safe, cost-effective, and medically necessary medication use. This role combines traditional dispensing responsibilities with prior authorization review and managed care coordination. Primary Responsibilities Process and dispense prescriptions accurately in compliance with state and federal regulations. Review patient profiles and insurance coverage to verify eligibility and benefit plan compliance. Perform prior authorization reviews for specialty and high-cost medications using established medical necessity criteria. Communicate with prescribers to clarify prescriptions, obtain additional clinical information, and resolve coverage issues. Apply critical thinking to assess treatment plans for appropriateness and safety using resources such as Medical Policy, Micromedex, and Care Management guidelines . Coordinate with specialty pharmacy vendors for approved authorizations and arrange medication shipment. Document all utilization decisions and communications accurately in pharmacy systems and EMR. Maintain compliance with state, federal, and accreditation standards for utilization review and pharmacy operations. Meet turnaround time and productivity goals for prior authorization and utilization review cases. Requirements Minimum 2 years of experience in retail pharmacy ; prior experience in utilization review, prior authorization, or managed care strongly preferred. Knowledge of insurance verification, formulary management, and specialty medication processes. Seniority level Mid-Senior level Employment type Contract Job function Health Care Provider Industries Hospitals and Health Care, Public Health, and Health and Human Services #J-18808-Ljbffr