Prior Authorization Pharmacy Technician (Seasonal) Remote

This is a 6 month contract position where you will assist members, providers, pharmacies, and the internal SmithRx teams to navigate complexities of prescriptions to guide timely coverage of clinically appropriate, cost effective medication therapy in accordance with plan benefit design and clinical criteria for coverage. This may involve coordination of clinical review cases, checking coverage and plan rules, verification of submitted information, pharmacy and provider outreach, review of prior authorization requests within established protocols, and assisting to triage and troubleshoot questions and escalations. At SmithRx, we design customized benefit plans for our customers and you are at the forefront of helping navigate and execute drug access. You will verify eligibility and drug coverage under the plan benefit design, triage the process of clinical review for prior authorization requests, organize and prioritize requests internally and externally, build and adjust authorizations, use pharmacy technician experience to navigate drug products, and work across teams to coordinate outreach for medication coverage. Evaluate member clinical situation against medication policies to approve or triage to Pharmacist for denial.