Prior Authorization Pharmacy Technician

About the position Oscar is hiring a Prior Authorization Pharmacy Technician to join their Pharmacy Tech team. Oscar is a health insurance company that utilizes a full stack technology platform and focuses on serving its members. The role is dedicated to high-quality pharmacy decision-making and improving the member and provider experience. This position is responsible for processing prior authorizations requests and providing support for escalated issues related to prior authorizations. Responsibilities • Use Oscar and vendor tools to determine eligibility, screen for required documents, create, process, and properly track pharmacy prior authorization requests • Prepare, organize, and distribute pharmacy prior authorization requests for review by pharmacist/physician and respond to pharmacist/physician requests for additional information • Collect relevant medical information (via telephone, fax, and portal) and apply the appropriate PA criteria, clearly documenting all communication and decision making • Meet required decision-making timeframes, including promptly triggering escalation for cases requiring pharmacist review • Communicate oral and written prior authorization outcome notifications that comply with standards and requirements for content and accuracy • Compliance with all applicable laws and regulations • Other duties as assigned Requirements • 2+ years of work experience in a pharmacy related field in a retail or managed care plan setting and/or prior authorization experience • Active, unrestricted Pharmacy Technician certification (CPhT) • Excellent customer service, phone etiquette, and typing skills Nice-to-haves • 1+ years of performing pharmacy reviews for a managed care plan or pharmacy benefits manager • Experience working with CVS Caremark's portal and criteria • In-depth understanding of how to operationalize step therapy rules and regulations • Strong verbal and written communications, and interpersonal interactions Benefits • medical • dental • vision benefits • 11 paid holidays • paid sick time • paid parental leave • 401(k) plan participation • life and disability insurance • paid wellness time and reimbursements • monthly vacation accrual at a rate of 15 days per year Apply tot his job Apply To this Job