Job Closed
This listing is no longer active.
Bringing our heart to every moment of your health.
Pharmacy Technician - Prior Authorization - Work From Home
Location
United States
Posted
100 days ago
Salary
$19 - $35 / hour
Seniority
Mid Level
No structured requirement data.
Job Description
Pharmacy Technician - Prior Authorization - Work From Home
CVS Health
We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary - Processes prior authorization requests received by phone, fax, or electronically and utilizes various computer resources, existing criteria, and medication guidelines to perform clinical research to support prior authorization reviews. - Proactively completes prior authorization approvals and denials that are due to expire and maintains complete, timely, and accurate documentation. - Reviews potential prior authorization denial language to ensure NCQA requirements are met. - Follows prior authorization workflow, policies, and procedures during the course of the workday. - Answers a potentially high volume of prior authorization inquiry calls from provider's offices, pharmacies, and internal partners and uses various computer resources to communicate prior authorization status or decisions. - Maintains a balance of productivity, quality and timeliness of work. - Participates in training and continuing education as required. - Participates in team/departmental meetings as required. - Excellent attendance is a must. - Successful pharmacy technicians will be proficient in drug name and diagnosis pronunciation, recognizing medical terminology, and navigating multiple computer resources to document conversations and prior authorization decisions. - Successful pharmacy technicians will possess good written and verbal communication skills. - Hours of operation for Aetna Pharmacy Prior Authorization are between 5:00am to 8:30pm (may vary by time zone). Pharmacy Technicians work 8 hours shifts that may fall in between these hours of operations. Work schedule is approximate, and hours/days may change based on company needs. All full-time employees are required to complete forty (40) hours per week as scheduled, including on weekends and holidays. Part time positions are not available. Position requires the ability to work extended hours when necessary. - Rotating weekend schedule may be required. - Candidate must have their own home internet access with minimum speed of 100mbps download (internet can be hard wired with Ethernet cord). - Candidate must also have a secure workspace/office in their home. - Candidate must have high level skill with working with PC (ex. using mouse and keyboard, accessing and navigating through multiple systems and screens). Work schedule is approximate and hours/days may change based on company needs. All full-time employees are required to complete forty (40) hours per week as scheduled, including on weekends and holidays. Part time positions are not available. Position requires the ability to work extended hours when necessary. Physical Demands: Frequent speaking and listening using a headset, sitting for long periods of time working at a computer, use of hands and fingers across keyboard or mouse, using computer monitors for up to 3 hours without a break. The physical demands and work environment characteristics described herein are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Required Qualifications - National Pharmacy Technician certification and applicable state Pharmacy Technician license, current and in good standing, are required and must be maintained. - Between 1-5+ years of Pharmacy Prior Authorization processing experience. - Ability to Multi-task and prioritize work. - Ability to adjust based on business or department needs. - Good organization skills - Must be able to work 12:00p - 8:30p in your time zone. Monday through Friday Preferred Qualifications - Retail or Hospital experience - Managed Care or Medicaid experience - AS400 experience - Proficiency in using computerized resources and software applications - Proficiency with Microsoft applications (Excel, Word, and Outlook) - Knowledge in pharmacy practices, procedures, and ability to read and understand clinical information - Working knowledge of drug dosage forms, drug strength, generic and brand name equivalent. Education - High School diploma, G.E.D. Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $18.50 - $35.29 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility. Additional details about available benefits are provided during the application process and on Benefits Moments. We anticipate the application window for this opening will close on: 04/17/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
Related Guides
Related Categories
Related Job Pages
More Human Resources Jobs
Nurse Practitioner
Monogram HealthMonogram Health is a leading multispecialty provider of in-home, evidence-based care for the most complex of patients who have multiple chronic conditions. Monogram Health takes a comprehensive and personalized approach to a person’s health, treating not only a disease, but all of the chronic conditions that are present. Employs a robust clinical team, leveraging specialists across multiple disciplines Available 24 hours a day, 7 days a week, and on holidays Proven to dramatically improve patient outcomes and quality of life while reducing medical costs
Job Description: Nurse Practitioner Monogram Health is looking for skilled Nurse Practitioners and Physician Assistants eager for the opportunity to make a difference in patients' lives. The Advanced Practitioner at Monogram Health is a key member of an integrated Care Team which includes a Registered Nurse and a Social Worker. The patients we serve often struggle with multiple serious diseases. Our Nurse Practitioners and Physician Assistants help patients improve their quality of life in the home and slow the progression of kidney disease, enabling positive health outcomes. Your Impact Using your skills in this position will allow you to deliver personalized compassionate medical care to individuals mainly with CKD and/or ESRD/ESKD. You will also be responsible for caring for patients, maintaining accurate and current patient records and scheduling, and administering follow-up appointments to patients as required. Your gifts as a healthcare professional are urgently needed. In healthcare systems, the patient has too often become secondary due to processes and incentives that don’t positively impact the patient for the long term. Here at Monogram, we strive to change that narrative by putting our patients and their quality of life at the forefront of what we do. Roles and Responsibilities - Conducts assessments, which includes comprehensive annual wellness exams on patients both in the patients' home and in the virtual environment - Counsels and educates patients and families about benefits and programs available to help them live healthier lives - Documents items such as: appropriate chief complaint, all applicable diagnosis, past medical, family, and social history, review of systems, examinations, medications, allergies, assessment, and plan - Responsible for the coordination of care with primary care providers, specialists, and appropriate ancillary services - Completes all documentation and paperwork in a timely manner - Maintains quality of care standards as defined by the practice - This position will not be office-based but will be remote in state in which employed and will need to attend periodic training/meetings outside of that state - Deliver evidence-based, timely care in a manner that reduces avoidable hospitalizations, maximizes quality of life, and puts patient health and satisfaction first - Prescribe medications, order tests, and collaborate with patient’s Monogram physician - Perform effectively, as reflected by improved patient quality outcomes, which will be measured and reported daily - Facilitates closing gaps in care by educating patients about preventive monitoring and working with physician practices to schedule diagnostic testing - Assists patients with enrolling to access educational videos - Participates in the integrated care team meetings - Knowledge of disease diagnosis and prevention - Make assessment of patient's health status - Develop treatment plan - Implement a plan consistent with appropriate plan of care - Follow-up and evaluate patient's status - Other duties as assigned Position Requirements - Active and unrestricted Registered Nurse and Nurse Practitioner or Physician Assistant license - Board certified for appropriate licensure (NP: ANCC/AANP; PA: NCCPA) - Current and unrestricted DEA certificate - Ability to work without direct supervision and practice autonomously - Access to transportation, a valid driver's license, and car insurance - Must be proficient with medical instruments and equipment required by the work - Knowledge of computer-based data management programs and information systems, as well as medical records and point-of-interview technology - Ability to communicate effectively in verbal and written form with retail and medical partners at various levels, patients, family members, physicians and representatives of the community - Sound understanding of all federal and state regulations including HIPAA and OSHA - 2 or more years of direct patient care required - Managed Care/IPA/Health Plan experience - Experience conducting annual wellness visits or similar comprehensive visits virtually or in the home Benefits - Comprehensive Benefits - Medical, dental, and vision insurance, employee assistance program, employer-paid and voluntary life insurance, disability insurance, plus health and flexible spending accounts - Financial & Retirement Support – Competitive compensation, 401k with employer match, and financial wellness resources - Time Off & Leave – Paid holidays, flexible vacation time/PSSL, and paid parental leave - Wellness & Growth – Work life assistance resources, physical wellness perks, mental health support, employee referral program, and BenefitHub for employee discounts - Earn a competitive base salary - Grow your clinical skillset and earn $2,500 for every core and specialty competency you complete - Invest in your longevity with a $5,000 annual anniversary bonus - Maximize your income potential with up to 15% in additional bonuses, including: - Start earning bonuses sooner — eligibility begins after just 3 months About Monogram Health Monogram Health is a leading multispecialty provider of in-home, evidence-based care for the most complex of patients who have multiple chronic conditions. Monogram health takes a comprehensive and personalized approach to a person’s health, treating not only a disease, but all of the chronic conditions that are present - such as diabetes, hypertension, chronic kidney disease, heart failure, depression, COPD, and other metabolic disorders. Monogram Health employs a robust clinical team, leveraging specialists across multiple disciplines including nephrology, cardiology, endocrinology, pulmonology, behavioral health, and palliative care to diagnose and treat health issues; review and prescribe medication; provide guidance, education, and counselling on a patient’s healthcare options; as well as assist with daily needs such as access to food, eating healthy, transportation, financial assistance, and more. Monogram Health is available 24 hours a day, 7 days a week, and on holidays, to support and treat patients in their home. Monogram Health’s personalized and innovative treatment model is proven to dramatically improve patient outcomes and quality of life while reducing medical costs across the health care continuum. #LI-CP1
Nurse Practitioner - House Calls - Statewide Traveler
UnitedHealth GroupUnitedHealth Group is a healthcare and well-being company that’s dedicated to improving the health outcomes of millions around the world. We are comprised of
Role Description This role requires travel across the entire state of Virginia, approximately 85% of the time. All travel expenses are covered, and there is likewise a base salary plus multiple incentives. You can live anywhere in the state for this role. In this role, you will have the ability to achieve work-life balance. Flexible scheduling is offered where providers can flex their time between 8am-8pm over the 7-day work week. No on-call, no weekends, and no holidays required. As a HouseCalls Advanced Practice Clinician (Nurse Practitioner or Physician Assistant), you will conduct annual in-home health assessments for Medicare Advantage and other plan members. This is a non-prescribing, field-based role focused on improving health outcomes through education, gap closure, and collaboration with primary care providers (PCP). Primary Responsibilities: - Conduct comprehensive in-home assessments, including: - Past medical history review, medication reconciliation, vital signs, and physical exam - Evidence-based screenings and point-of-care testing (as appropriate) - Identify and document diagnoses for care management and treatment planning - Communicate findings to members’ PCPs to address gaps in care - Recognize urgent/emergent situations and intervene appropriately - Educate members on disease processes, medications, and compliance - Address social determinants of health and provide referrals as needed You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Qualifications - For NPs: Active ANCC or AANP certification in Family, Adult, Geriatric, or Adult-Gerontology Primary Care - For PAs: Current NCCPA certification and state licensure - Active, unrestricted licensure in the state you will be practicing in (or ability to obtain by start date) without current disciplinary actions or practice limitations - Active and unrestricted driver’s license - In addition to a driver’s license, access to reliable transportation to complete home visits - Ability to navigate varied home environments; ability to sit/stand/kneel as needed to perform assessments - If you're working in a state that allows NPs/PAs to practice independently (without Collaborative Agreement), you must get approval from your licensing board—if required. New hires who are eligible but haven’t applied yet must do so within 1 month of starting. If you're not eligible at the time of hire, you must begin working toward eligibility within 1 month and apply for approval within 3 months of becoming eligible. Preferred Qualifications - 1+ years of clinical experience (family, geriatric, or home health preferred) - Proficiency with electronic medical records and technology - Ability to transport equipment weighing up to 30 pounds and navigate stairs as part of home visits - Proven communication skills with geriatric or Medicare populations Compensation Compensation for this specialty generally ranges from $109,500 - $164,000. Total cash compensation includes base pay and bonus and is based on several factors including but not limited to local labor markets, education, work experience and may increase over time based on productivity and performance in the role. We comply with all minimum wage laws as applicable. In addition to your salary, we offer benefits such as: - A comprehensive benefits package - Incentive and recognition programs - Equity stock purchase - 401k contribution (all benefits are subject to eligibility requirements) No matter where or when you begin a career with us, you’ll find a far-reaching choice of benefits and incentives.
Role Description Erikson adjunct faculty are part-time instructors in one of Erikson’s academic programs – Master of Social Work, Master of Early Childhood Education leading to Licensure, Master of Early Childhood Education Online, Master of Child Development, and certificate programs. Teaching may include day, evening, as well as, asynchronous and synchronous online courses and seminars. Adjunct instructors report to the Program Director of the academic program in which they teach. This course requires specialized knowledge and experience in conducting parent-child relationship assessment. The instructor must be proficient in the Working Model of the Child Interview (WMCI), the PICCOLO, the ITSEA, The Crowell, and The FEAS. A minimum of a master’s degree is required. Experience in teaching in higher education is preferred. This is an online course conducted on the learning platform Canvas. Experience with Canvas is preferred. Qualifications - A minimum of a master’s degree in social work, psychology, child development, or a related field is required. - Demonstrated knowledge of and commitment to diversity, equity, inclusion, justice, and belonging. - For IECMH Certificate Program applicants: a strong background in infant mental health theory and practice principles and experience working in the field. Requirements - Prepare and organize for class and engage with students in an online and/or on-campus format. - Teach seminars and supervise internships/field placements, and independent study projects as needed. - Create a learning environment that encourages student involvement and participation. - Consider individual differences of students to design and support a range of appropriate learning activities. - Use a variety of assessment methods to allow students to demonstrate knowledge, practice, and reflection. - Evaluate teaching and assessment methods and use data to continually improve instructional strategies. - Use a variety of instructional methods and technologies to enhance classroom and/or online instruction. - Adhere to course-specific learning outcomes and participate in assessment and accreditation activities. - Maintain attendance records and inform Registration and Records regarding enrollment errors and administrative withdrawals. - Discuss performance and provide constructive feedback to students throughout the semester. - Maintain up-to-date grades in Canvas and submit end of semester grades on time. - Maintain up-to-date syllabi that clearly outline course requirements, goals, objectives, and institutional policies. - Submit required textbooks and digital copies of syllabi to the library for each semester. - Provide a schedule of teaching and office hours. - Review and grade capstone projects as needed. - Advise students about the program to assist them with informed decisions leading to degree or certificate completion. - Refer students to appropriate academic support services available. - Help students develop professional habits for the field by reinforcing student technical standards. - Participate in adjunct faculty and staff meetings, and commencement exercises. - Continue professional development and growth according to personal needs and certification requirements. - Maintain professional competence in the specific discipline or field of study. - Complete all mandatory performance evaluation measures within specified time limits. - Adhere to all institute policies and procedures related to academic programs. - Perform other duties as assigned. Company Description
Senior HR BPO Delivery Analyst
StradaWe’re Strada, a global pioneer in payroll, human capital, and financial management solutions.
• responsible for day-to-day productivity across assigned clients • monitor workload ensuring projects delivered on time with quality • develop solutions to complex problems • act as subject matter expert, executing deliverables for clients • support opportunities for process optimization and automation


