Pharmacy Technician

100% Remote Prior Authorization Pharmacy Technician

Job Description

This remote Pharmacy Technician position focuses on reviewing prior authorization requests and making coverage determinations for a large pharmacy services department within a national health insurance organization. You will evaluate requests for a wide range of medications across multiple health plans, approve or deny based on established criteria, and route decisions to a pharmacist for final review. This role offers minimal phone work, a structured remote environment, and a long-term career path with the opportunity to convert to a permanent role with benefits.

Responsibilities

• Review prior authorization requests for prescription medications across multiple health plans and drug types.
• Evaluate coverage determination requests using established clinical and benefit criteria.
• Approve or deny requests within scope and route decisions to a pharmacist for final review.
• Track coverage determination requests accurately and in a timely manner.
• Enter all decisions and relevant information into the pharmacy benefit management (PBM) system and other internal systems.
• Notify providers and members of coverage decisions in accordance with department procedures.
• Obtain verbal authorizations from prescribers and other authorized parties as needed.
• Request and collect detailed clinical information from prescribers to support coverage decisions.
• Respond to client and internal inquiries regarding prior authorization status, requirements, and outcomes.
• Refer requests involving specialty drugs and complex cases to the appropriate clinical or specialty teams.
• Contact providers to clarify prescriptions, obtain missing information, or resolve discrepancies.
• Notify all relevant stakeholders of decision outcomes, including approvals, denials, and requests for additional information.
• Assist with inbound and outbound calls to patients or physicians when needed, primarily for information gathering or notification purposes.
• Use multiple computer systems and screens simultaneously to research, document, and process requests.
• Maintain high standards of accuracy, confidentiality, and compliance with all applicable policies and regulations.
• Provide professional customer service to members, providers, and internal partners while representing the pharmacy services department.

Essential Skills

• Current registration as a Pharmacy Technician in the state of residence, in good standing.
• National certification as a Pharmacy Technician (such as PTCB or NHA).
• High school diploma or GED.
• Demonstrated strong computer skills, including working efficiently with multiple screens and systems.
• Basic proficiency with Microsoft Office applications, including Outlook.
• Accurate and efficient data entry skills.
• Experience working as a pharmacy technician in settings such as retail pharmacy, hospital, PBM, specialty pharmacy, or call center environments.
• Understanding of prescription benefits and insurance processes, including Medicare and Medicaid.
• Ability to interpret and process prior authorization requests and related documentation.
• Strong attention to detail and ability to follow established criteria and procedures.
• Effective written and verbal communication skills for interacting with providers, members, and internal teams.
• Ability to work scheduled shifts, including evenings within the 8:00 a.m. to 8:00 p.m. window in the local time zone, rotating weekends, and some holidays.

Additional Skills & Qualifications

• Pharmacy Technician Certification (CPhT) through PTCB, NHA, or equivalent national certifying body.
• Registered Pharmacy Technician or Certified Pharmacy Technician credentials as recognized by the state of operation.
• Experience with pharmacy benefit management (PBM) systems and processes.
• Experience in retail pharmacy, hospital pharmacy, specialty pharmacy, or prescription benefits administration.
• Customer service experience, particularly in a healthcare or call center environment.
• Familiarity with health insurance plans, coverage policies, and prior authorization workflows.
• Ability to manage multiple tasks simultaneously while maintaining accuracy and meeting productivity metrics.
• Self-motivated and disciplined approach to work in a remote, performance-driven environment.
• Interest in long-term career growth within a large, nationwide healthcare organization.

This is a Contract to Hire position based out of Boston, MA.

The pay range for this position is $18.00 - $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)

This is a fully remote position.

This position is anticipated to close on Jun 17, 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 30,000 consultants and more than 4,500 clients across the U.S.,

Canada, Asia and Europe, Actalent serves many of the Fortune 500.

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 ... 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.