Role Description This position is available to work from home from within the Sutter Health Northern California footprint. Responsible for performing the appropriate processes to verify patient eligibility, coordinate benefits, ensure insurance coverage, and determine if prior authorization is needed for said order. If needed, obtains authorization and documents in the patient electronic medical record. Facilitates responses to patient inquiries regarding authorizations within turnaround standards. Qualifications - HS Diploma or GED - 1 year recent relevant experience Requirements - Medical terminology knowledge - Current Procedural Terminology (CPT)/Healthcare Common Procedure Coding System (HCPCS)/International Classification of Diseases (ICD)-9 coding knowledge - Knowledge of medical terminology/anatomy - Ability to exercise discretion and make independent judgments, seeking review when decisions represent significant departure from established guidelines - Knowledge of Microsoft Office programs including Excel, Word or similar programs - Ability to maintain composure during challenging interpersonal interactions - Active listening skills; including interpersonal skills and telephone communication - Organizational skills with attention to detail and follow-up Benefits - Eligible positions include a comprehensive benefits package Company Description Sutter Health is an equal opportunity employer EOE/M/F/Disability/Veterans. Pay Range is $27.50 to $34.37 / hour. The compensation range may vary based on the geographic location where the position is filled. Total compensation considers multiple factors, including, but not limited to a candidate’s experience, education, skills, licensure, certifications, departmental equity, training, and organizational needs. Base pay is only one component of Sutter Health’s comprehensive total rewards program.

Role Description The Pharmacy Technician I supports the organization’s mission and purpose by providing front-line customer support for a diverse portfolio of customers. The incumbent will handle inbound telephone inquiries from Members, pharmacies, and Prescribers in our National Customer Care Center, and will consistently meet established productivity, schedule adherence, and quality standards. Work Arrangement: Remote Responsibilities - Provide real-time support to pharmacies with point-of-service inquiries - Educate prescribers on formulary and prior authorization processes - Enter customer data and other relevant information into our documentation tool - Assist members with pharmacy benefit inquiries - Adhere to standard operating procedures to ensure contact handling accuracy and operational effectiveness - Effectively communicate issues and resolutions to customers and appropriate internal staff Qualifications - Bachelor's degree or equivalent experience required - Minimum three (3) years of current/recent PBM and/or current/recent pharmacy experience required Requirements - Active/current National Pharmacy Technician Certification (NHA or PTCB) or ability to obtain one within the first six (6) months of employment is required Benefits - Flexible work solutions include remote options - Competitive pay - Paid Time Off (PTO), including holidays and volunteer events - Health insurance coverage for you and your dependents on Day 1 - 401(k) - Tuition reimbursement - And more

• Responsible for the design, configuration, and quality assurance of prior authorization (PA) criteria • Ensures clinical intent is accurately translated into compliant, efficient system logic through structured QA/QC and validation processes • Collaborates with internal teams and external clients to support delegated PA services and drive system optimization • Build decision trees and question sets from PA criteria for prior authorization review • Perform comprehensive quality control (QC) review of decision trees, questionnaires, and authorization logic to ensure alignment with clinical intent, regulatory requirements, and business rules • Conduct quality assurance (QA) validation of configured criteria and decision paths • Ensure PA questionnaires are configured with the appropriate authorization parameters for approval • Collaborate with external clients for delegated clinical PA systems services • Manage setup, contracting, and relationships with prior authorization external vendors • Mapping of prior authorization member and prescriber letter templates in the prior authorization system • Validate that denial rationales, approval language, and conditional messaging accurately reflect clinical criteria and system outputs • Creation and maintenance of Commercial and Government denial verbiage templates • Develops and maintains policies and procedures for creation and maintenance of clinical criteria questions and letter templates • Establish and maintain QA/QC standards, documentation, and audit processes for decision trees, criteria configurations, and letter templates • Identify PA reporting needs and collaborating with appropriate stakeholders to develop reports • Respond to requests for clinical criteria from members and prescribers • Attend formulary meetings and presentations

Role Description The Pharmacy Service Associate is responsible for performing daily, routine tasks in the pharmacy such as answering the phone, responding to customer requests, data entry, record maintenance, and other clerical duties. - Answers inbound calls to the Pharmacy - Communicates with Patients regarding their medication orders, including verifying order status - Responds to requests and communicates with Lincare Center staff regarding patient medication orders - Places medication refill order in computerized system at patient request - Assesses customer compliance with physician orders - Answers questions and provides customer education regarding products/services, within Board of Pharmacy Regulations - Submits requests for special orders as needed - Tracks medication packages in various vendor systems such as UPS - Researches order status and delivery at patient or center request - Inactivates patient accounts in computerized system - Processes patient address changes, ensuring accurate address information - Responsible for meeting specific performance objectives related to number of calls handled, orders processed, time on call, time entering information in computerized system, etc. - Complies with Board of Pharmacy rules and regulations Qualifications - High School Diploma or General Education Degree (GED), Required - Minimum of one-year clerical/office experience, required - Strong phone, verbal, and written communication skills - Problem-solver - Proficiency in Microsoft Office applications - Adequate typing (typically 30 -- 40 wpm) - Successfully complete Pharmacy Technician Training program and obtain Pharmacy Technician Registration within required timeframe - For Med4Home positions, Pharmacy Technician License is required in state of jurisdiction Benefits - Ongoing training and advancement opportunities - Comprehensive medical, dental, and vision coverage - Paid time off - Retirement savings - Tuition reimbursement - Generous employee referral program - Wide array of employee discounts