Pharmacy Technician (Medical Pharmacy / Part B)

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.

Pharmacy Technician - Medical Pharmacy / Part B - Remote / WFH

Position Purpose: The Pharmacy Technician will perform duties reviewing coverage for medications under the Medical benefits for Medicare, Medicaid, and Exchange plans.

Using established company guidelines, the Pharmacy Technician reviews requests made by physicians, medical groups, pharmacies and members for the use of prescription drugs and pharmacy benefits. The technician researches and resolves questions, problems or issues. May consult with Clinical Pharmacists or Regional Medical Director on related issues.

Prior Authorization Medicare Part B
Tracks and triage coverage determination and/or prior authorization requests submitted from providers and determine if a pharmacist review is required.
Obtains verbal authorizations and request detailed clinical information from prescribers.
Approves coverage determination and/or prior authorization requests based on defined criteria.
Enters and documents coverage determination and/or prior authorization request decisions into the PBM system and notify providers and/or members.
Responds to client inquiries regarding authorization approvals and PBM online applications.
Refers coverage determination requests for specialty drugs to delegated vendor or client for processing.
Contacts providers for additional information to facilitate coverage determination reviews.
Notifies physicians, providers, and members of coverage determination request decisions.

Education/Experience: High School diploma or GED required. 1 year Pharmacy Technician experience. Medical Pharmacy - Medicare Part B, Medicaid and/or Exchange coverage determination and/or prior authorization in Managed Care (MCO), hospital, and/or medical facility experience preferred.

License/Certification: Valid Pharmacy Technician License preferred.

Shift / Training:

First 90 days: 10am-6:30pm Monday - Friday (EST)

After 90 days: Choice of 10am – 6:30pm Tuesday – Saturday (EST) or 10am – 6:30pm Sunday - Thursday (EST), depending on business need.

The latest shift available after 90 days is 12pm-8:30pm (EST). The Saturday or Sunday shift are 8am – 4:30pm or 9:30pm – 6pm (EST).

Our Comprehensive Benefits Package: Flexible work solutions including remote options, hybrid work schedules and dress flexibility, Competitive pay, Paid time off including holidays, Health insurance coverage for you and your dependents, 401(k) and stock purchase plans, Tuition reimbursement and best-in-class training and development.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.