100% Remote Certified Pharmacy Technician

Remote Pharmacy Technician Prior Authorization

This remote Pharmacy Technician role focuses on reviewing pharmacy prior authorization requests and supporting coverage determinations for a large healthcare insurance pharmacy services department. You will evaluate requests against established criteria, approve or deny them, and route decisions to pharmacists for final review, while working across multiple health plans and medication types with minimal phone work.

Responsibilities include:

• Review pharmacy prior authorization requests for coverage determination across multiple health plans and all types of medications.
• Evaluate requests based on established clinical and benefit criteria, making an initial approval or denial decision.
• Enter coverage determination decisions accurately into the pharmacy benefit management (PBM) system.
• Track coverage determination requests from receipt through final decision, ensuring timely processing.
• Obtain verbal authorizations from prescribers and providers when required.
• Request and collect detailed clinical information from prescribers to support coverage decisions.
• Notify providers, members, and other stakeholders of coverage determination outcomes in a clear and timely manner.
• Respond to client and provider inquiries related to prior authorizations, coverage criteria, and decision status.
• Refer requests involving specialty medications or complex cases to appropriate specialty pharmacy or clinical teams.
• Contact providers for additional information or clarification when documentation is incomplete or unclear.
• Assist with inbound and outbound patient or physician calls as needed, with most phone work being outbound.
• Use multiple computer systems and screens simultaneously to research member benefits, medication coverage, and prior authorization status.
• Perform accurate and efficient data entry of prior authorization details, member information, and decision notes.
• Maintain a high level of customer service and professionalism in all written and verbal communications.
• Adhere to all regulatory, compliance, and internal policy requirements related to pharmacy services and prescription benefits.
• Meet performance metrics and productivity standards while maintaining accuracy and quality.
• Collaborate with pharmacists by routing cases for final review and following any additional instructions or clarifications.
• Protect member privacy and handle sensitive health information in accordance with applicable regulations and company policies.
• Participate in training and ongoing education to stay current on plan changes, medication policies, and prior authorization criteria.

Essential skills include:

• Current registration as a pharmacy technician in the state of residence.
• National certification as a Certified Pharmacy Technician (such as PTCB or NHA).
• High School diploma or GED.
• Strong computer skills, including the ability to work in multiple systems and on multiple screens simultaneously.
• Proficiency with basic computer applications and Microsoft Office tools, including Outlook.
• Accurate and efficient data entry skills.
• Experience with pharmacy operations, such as retail pharmacy, hospital pharmacy, specialty pharmacy, or PBM environments.
• Understanding of prior authorization processes and prescription benefit management.
• Knowledge of Medicare and Medicaid prescription benefits is strongly preferred.
• Customer service skills with the ability to communicate clearly and professionally with providers, members, and colleagues.
• Ability to work remotely with reliable high-speed Wi-Fi and a dedicated workspace with a closing door.
• Capability to manage inbound and outbound calls in a call center or similar environment when needed.
• Ability to work Monday through Friday between 8:00 a.m. and 8:00 p.m. in the local time zone, including participation in a rotating weekend and holiday schedule.
• Comfort with minimal phone work, focusing primarily on system-based review and documentation.

Additional skills and qualifications include:

• Registered Pharmacy Technician credential in the state of residence.
• Certified Pharmacy Technician designation (e.g., PTCB or NHA certification).
• Experience working in a pharmacy benefit management (PBM) setting or with prescription benefit plans.
• Familiarity with call center operations and workflows.
• Strong attention to detail and ability to maintain accuracy while working with high volumes of requests.
• Organizational skills to manage multiple cases and tasks in a fast-paced environment.
• Ability to meet and maintain performance metrics and quality standards.
• Interest in long-term career growth within a nationwide healthcare organization.
• Motivation to transition from contract to permanent employment with access to benefits and paid time off.

Work environment:

This position operates in a professional remote work environment supporting a nationwide healthcare organization. Pharmacy technicians work from their own home office space, which must have a closing door to ensure privacy and confidentiality, and must be equipped with strong, reliable Wi-Fi. The role requires working on multiple computer screens and within multiple systems at the same time. The company provides essential equipment, including a computer, monitor, and headset, while the technician supplies their own workspace and smartphone. Training is conducted remotely and runs from 10:00 a.m. to 6:30 p.m. Eastern Time; after training, technicians receive their regular schedules, which are published three months in advance. Work hours require availability Monday through Friday from 8:00 a.m. to 8:00 p.m. in the technician's local time zone, with participation in a rotating weekend schedule approximately every 46 weeks and some holiday coverage determined through a bidding process. The environment emphasizes professionalism, performance metrics, and accuracy, and offers flexibility for individuals who demonstrate strong performance, meet metrics, and build tenure, along with the potential to transition into a permanent role with benefits and paid time off.

Job type and location:

This is a Contract to Hire position based out of Chicago, IL.

Pay and benefits:

The pay range for this position is $20.00 - $23.00/hr. 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 type:

This is a fully remote position.

Application deadline:

This position is anticipated to close on Jul 15, 2026.

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 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