Pharmacy Technician

Pharmacy TechnicianThe Pharmacy Technician supports multiple pharmacy operations areas, including formulary management, pharmacy audit and recovery, service center activities, Medicare Part D and B, appeals, and state health program pharmacy operations. Working within established guidelines, this role reviews prescription drug and pharmacy benefit requests submitted by physicians, medical groups, pharmacies, and members, and helps ensure accurate, timely, and compliant determinations. The Pharmacy Technician researches and resolves questions and issues, and collaborates closely with clinical pharmacists and medical leadership when needed.ResponsibilitiesReview prior authorization requests for prescription drugs and pharmacy benefits submitted by physicians, medical groups, pharmacies, and members in accordance with established guidelines and criteria.Perform Intake activities by accurately typing all information from prior authorization request forms into the Compass case management system.Conduct Technician Review by verifying the accuracy of intake data and comparing the prior authorization request and clinical documentation against the appropriate clinical criteria.Determine whether requests can be approved based on established criteria and available clinical information.Identify missing or incomplete information and contact provider offices to obtain the documentation needed to complete the review.Route cases requiring denial decisions to the pharmacist queue for additional review and confirmation.Remediate cases that require overturning a determination or correcting an error, ensuring all updates are accurately documented in the system.Move completed cases to the Manual Outreach queue and contact providers and/or members by phone or fax to communicate final decisions.Research and resolve questions, problems, or issues related to prescription drug coverage and pharmacy benefits in a timely and professional manner.Consult with Clinical Pharmacists or Regional Medical Directors on complex or unclear cases requiring clinical judgment.Maintain a high level of accuracy and attention to detail in data entry, documentation, and case processing.Use collaboration tools such as Teams and Outlook to communicate with team members, participate in meetings, and maintain strong connectivity in a remote environment.Essential SkillsActive pharmacy technician license, with the ability to perform technician duties in accordance with applicable regulations.Minimum of 2 years of experience as a Pharmacy Technician.Experience working in pharmacy settings such as retail, managed care, or similar environments involving claims and prior authorizations.Proficiency in accurate and efficient data entry.Ability to interpret and apply established formulary, coverage, and prior authorization criteria.Strong attention to detail and accuracy when reviewing clinical documentation and case information.Effective verbal and written communication skills for interacting with provider offices, members, and internal clinical staff.Proficiency with Microsoft Teams, Outlook, Word, Excel, and OneNote.Ability to work effectively in a structured, guideline-driven environment and follow standardized processes.Capability to work independently in a remote setting while remaining engaged and responsive to team communication.Additional Skills & QualificationsCustomer service or retail experience, particularly in pharmacy or healthcare settings, is preferred.Experience in managed care pharmacy, including exposure to claims processing or prior authorization workflows, is beneficial.Comfort working with multiple technology platforms and case management systems such as Compass or similar tools.Strong organizational skills and the ability to manage workload and priorities within defined timeframes.Ability to collaborate with pharmacists and clinical leadership on complex cases and follow through on remediation tasks.Work EnvironmentThis is a fully remote role that operates within a highly connected and collaborative virtual team. Most daily interaction with colleagues takes place through Microsoft Teams using chat, audio or video calls, and screen sharing, while Outlook is heavily used for email and team communications. The schedule during the training period, which typically ranges from 12 to 24 weeks, is Monday through Friday from 10:00 a.m. to 6:30 p.m. Eastern Time. After training, the standard schedule shifts to Tuesday through Friday from 12:30 p.m. to 9:00 p.m. Eastern Time, and Saturday from 8:00 a.m. to 4:30 p.m. Eastern Time. Overtime is not expected. The work is computer-based, requires consistent access to reliable internet, and involves extensive use of Microsoft Office applications and internal case management systems in a professional, structured environment.Job Type & LocationThis is a Contract to Hire position based out of Houston, TX.Pay and BenefitsThe pay range for this position is $18.00 - $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)Workplace TypeThis is a fully remote position.Application DeadlineThis position is anticipated to close on Sep 1, 2026.About ActalentActalent 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 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 process due to a disability, please email View email address on click.appcast.io for other accommodation options.San Francisco Fair Chance Ordinance: Pursuant to the San Francisco Fair Chance Ordinance, for all positions located in the city and county of San Francisco, we will consider for employment qualified applicants with arrest and conviction records.Massachusetts Lie Detector: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall 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 applications and qualifications, but final decisions are made by our hiring team. By applying, you acknowledge and agree that your application may be reviewed using AI tools.