Experienced Pharmacy Technician for Prior Authorization Review - Remote Opportunity with Molina Healthcare

Transforming Healthcare through Expertise and Innovation

Molina Healthcare, a leading organization in healthcare management, is seeking a highly skilled and experienced Pharmacy Technician to join our team as a Prior Authorization Review Specialist. This role is a unique opportunity to work remotely and be part of a dynamic team that is dedicated to ensuring that our members have access to necessary prescription medications in a safe and cost-effective manner.

About Us

Molina Healthcare is committed to providing high-quality healthcare services to our members, and our Pharmacy Services team plays a critical role in achieving this goal. Our team works tirelessly to create, operate, and monitor pharmacy benefit programs that comply with all federal and state laws, ensuring that our members receive the medications they need while promoting safe and effective medication use.

Job Overview

As a Pharmacy Technician for Prior Authorization Review, you will be responsible for reviewing prior authorization requests for medications, assisting in determining medical necessity, and resolving pharmacy claims issues. This role requires a high level of expertise, strong communication skills, and the ability to work effectively in a fast-paced, remote environment.

Key Responsibilities

• Review prior authorization requests for medications against plan-approved criteria and request additional information from providers as needed.
• Accurately enter online approvals or denials of requests and make simple prior authorization decisions within established policies and procedures.
• Participate in the development and administration of programs designed to enhance the utilization of targeted drugs and identify cost-saving pharmacy practices.
• Identify and report departmental operational issues and resource needs to management.
• Assist Molina Member Services, pharmacies, and health plan providers in resolving member prescription claim, prior authorization, or pharmacy services access issues.
• Articulate Pharmacy Management policies and procedures to pharmacy/health plan providers, other Molina staff, and others as needed.

Essential Qualifications

To be successful in this role, you must possess the following essential qualifications:

• High School Diploma or GED equivalent.
• Active and unrestricted Pharmacy Technician Certification (e.g., PTCB certification).
• 2 years of experience as a Pharmacy Technician.
• Prior Authorization experience.
• Strong computer skills, with the ability to work within multiple computer systems simultaneously.
• Excellent written and verbal communication skills.

Preferred Qualifications

While not required, the following qualifications are highly preferred:

• Associate degree.
• 3+ years of experience as a Pharmacy Technician.
• Managed care experience.
• Call center experience.

Skills and Competencies

The ideal candidate will possess a unique combination of technical, business, and interpersonal skills, including:

• Knowledge of pharmacy benefit management principles and practices.
• Ability to analyze complex information and make informed decisions.
• Strong problem-solving and critical thinking skills.
• Excellent customer service skills, with the ability to effectively communicate with diverse stakeholders.
• Ability to work effectively in a remote environment, with minimal supervision.

Career Growth Opportunities

At Molina Healthcare, we are committed to supporting the career growth and development of our employees. As a Pharmacy Technician for Prior Authorization Review, you will have opportunities to:

• Develop your skills and expertise in pharmacy benefit management.
• Participate in training and development programs to enhance your knowledge and competencies.
• Advance to leadership roles or specialized positions within the organization.

Work Environment and Company Culture

Molina Healthcare is a dynamic and inclusive organization that values diversity, equity, and inclusion. As a remote employee, you will be part of a collaborative and supportive team that is passionate about delivering high-quality healthcare services to our members.

Compensation and Benefits

Molina Healthcare offers a competitive compensation and benefits package, including:

• A competitive salary.
• A comprehensive benefits package, including medical, dental, and vision coverage.
• Opportunities for career growth and professional development.
• A dynamic and supportive work environment.

Join Our Team

If you are a motivated and experienced Pharmacy Technician looking for a challenging and rewarding opportunity, we encourage you to apply for this role. As a member of our team, you will play a critical role in shaping the future of healthcare and making a positive impact on the lives of our members.

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