Pharmacy Technician Prior Authorization (Fully Remote)

Overview

This role supports the Pharmacy Services department by reviewing prior authorization requests for medications covered under governmentsponsored health plans such as Medicare and Medicaid. You will manage a highvolume queue of coverage determination cases, verify member eligibility, assess requests against plan criteria, and ensure timely, accurate decisions. Prior authorization experience and previous remote work experience are highly preferred.

• This position begins as a 6month contract with high likelihood of extension and future potential for permanent hire, contingent on performance.

Key Responsibilities

• Coverage Determination Review Evaluate prior authorization requests submitted by providers to determine if criteria are met for approval.
• Case Triage Track, sort, and route incoming requests; identify when pharmacist review is required.
• Clinical Information Gathering Contact prescribers to obtain missing details needed to complete a determination.
• Decision Processing Approve requests when criteria are clearly met; escalate specialty drug cases to delegated vendors when appropriate.
• Documentation Enter decisions into the PBM system with accurate, complete notes.
• Provider & Member Communication Notify physicians, providers, and members of determination outcomes.
• Client Support Respond to inquiries regarding authorization approvals and PBM online applications.
• Information FollowUp Reach out to providers for additional details needed to finalize reviews.

Schedule & Work Environment

• Training: 10:00am6:30pm EST for the first 5 weeks.
• PostTraining Schedule: Set shift between 8:00am8:00pm EST (examples: 85, 96, 107).
• Remote: Fully remote role; prior remote experience strongly preferred.
• Weekends: Rotating weekend coverage every 56 weeks.
• Holidays: Rotating holiday coverage; must be willing to work holidays as needed.

Qualifications

• Prior authorization experience is required.
• 2+ years of pharmacy technician experience in a managed care or prior authorization setting.
• NHA or PTCB certification preferred but not required.
• Previous experience working in a remote environment highly preferred, with strong self management skills.
• Strong communication skills when interacting with providers and members.
• Ability to work efficiently in a fastpaced, highvolume queue.
• Comfortable navigating PBM systems and documenting case decisions accurately.

Job Type & Location This is a Contract position based out of St. Louis, MO. Pay and Benefits The pay range for this position is $20.00 - $23.00/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) Job Type & Location This is a Contract position based out of St. Louis, MO. Application Deadline This position is anticipated to close on Oct 24, 2026. Workplace Type This is a fully remote position. 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 actalentaccommodation@actalentservices.com 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. Pharmacy Technician Prior Authorization (Fully Remote)

Overview

This role supports the Pharmacy Services department by reviewing prior authorization requests for medications covered under governmentsponsored health plans such as Medicare and Medicaid. You will manage a highvolume queue of coverage determination cases, verify member eligibility, assess requests against plan criteria, and ensure timely, accurate decisions. Prior authorization experience and previous remote work experience are highly preferred.

• This position begins as a 6month contract with high likelihood of extension and future potential for permanent hire, contingent on performance.

Key Responsibilities

• Coverage Determination Review Evaluate prior authorization requests submitted by providers to determine if criteria are met for approval.
• Case Triage Track, sort, and route incoming requests; identify when pharmacist review is required.
• Clinical Information Gathering Contact prescribers to obtain missing details needed to complete a determination.
• Decision Processing Approve requests when criteria are clearly met; escalate specialty drug cases to delegated vendors when appropriate.
• Documentation Enter decisions into the PBM system with accurate, complete notes.
• Provider & Member Communication Notify physicians, providers, and members of determination outcomes.
• Client Support Respond to inquiries regarding authorization approvals and PBM online applications.
• Information FollowUp Reach out to providers for additional details needed to finalize reviews.

Schedule & Work Environment

• Training: 10:00am6:30pm EST for the first 5 weeks.
• PostTraining Schedule: Set shift between 8:00am8:00pm EST (examples: 85, 96, 107).
• Remote: Fully remote role; prior remote experience strongly preferred.
• Weekends: Rotating weekend coverage every 56 weeks.
• Holidays: Rotating holiday coverage; must be willing to work holidays as needed.

Qualifications

• Prior authorization experience is required.
• 2+ years of pharmacy technician experience in a managed care or prior authorization setting.
• NHA or PTCB certification preferred but not required.
• Previous experience working in a remote environment highly preferred, with strong self management skills.
• Strong communication skills when interacting with providers and members.
• Ability to work efficiently in a fastpaced, highvolume queue.
• Comfortable navigating PBM systems and documenting case decisions accurately.

Job Type & Location This is a Contract position based out of St. Louis, MO. Pay and Benefits The pay range for this position is $20.00 - $23.00/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) Job Type & Location This is a Contract position based out of St. Louis, MO. Application Deadline This position is anticipated to close on Oct 24, 2026. Workplace Type This is a fully remote position. 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 actalentaccommodation@actalentservices.com 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.