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Position Summary:
- Leads non-clinical administration of pharmacy utilization management (UM) programs.
- Receives, processes, and conducts non-clinical review of prior authorization requests.
- Escalates non-standard situations to a pharmacist and exercises discretion on operational matters.
What you will do:
- Manage UM operations: verify benefits, maintain records, communicate with providers, and monitor work queues.
- Coordinate workflow, prioritize requests, and resolve non-clinical issues.
- Support technology implementation, testing, and process improvements.
What you need:
- Bachelor’s degree in healthcare or related field.
- 5+ years of pharmacy technician experience, including 3 in UM or PBM operations.
- Active CPhT credential and state registration; experience in senior or trainer roles.
What you get:
- Impact industry change in pharmacy benefits management.
- Work in a thriving culture with competitive compensation.
- Access to health, dental, vision, and other benefits.
AffirmedRx
AffirmedRx aims to improve healthcare outcomes by bringing clarity and trust to pharmacy benefit management. They are a growing company focused on clinical approaches and state-of-the-art technology, with a culture that promises to do what's right.