Pharmacy Prior Authorization Technician

Description

Professional - Clinical

Req # : 43030

Summary :

The Pharmacy Prior Authorization Technician is responsible for coordinating and processing prior authorizations (PAs) for prescription medications to ensure timely patient access to treatment. Working closely with providers, pharmacists, payers, and patients, the technician utilizes the EHR and payer portals to facilitate and document the PA process. This role is key to supporting the clinical team in minimizing treatment delays and improving medication access. This is a hybrid role that allows working remotely with the ability to come in-office for training and as needed. All experience levels are encouraged to apply. This role is included in th pharmacy technician ladder program, with compensation accounting for experience and certification.

Key Responsibilities

• Review medication orders routed to queue
• Initiate and complete prior authorization requests through electronic portals (e.g., CoverMyMeds, Surescripts, payer websites).
• Communicate with insurance companies to gather coverage requirements and status updates.
• Collaborate with providers and pharmacists to obtain necessary clinical documentation for PA submissions.
• Document PA status, approvals, denials, and follow-ups
• Notify providers of PA outcomes and assist with alternative medication strategies when necessary.
• Track and manage open prior authorizations to ensure timely resolution and refill coordination.
• Support clinic staff, pharmacy staff and patients by providing status updates or coverage information as allowed.
• Maintain up-to-date knowledge of payer formulary changes and authorization requirements.
• Participate in continuous quality improvement and workflow optimization efforts.
• Other pharmacy technician tasks as assigned

Required Minimum Knowledge, Skills, and Abilities (KSAs)

Additional Information

With a career at any of the MaineHealth locations across Maine and New Hampshire, you'll be working with health care professionals that truly value the people around them - both within the walls of the organization and the communities that surround it.

We offer benefits that support an individual's needs for today and flexibility to plan for tomorrow - programs such as paid parental leave, a flexible work policy, student loan assistance, training and education, along with well-being resources for you and your family.

MaineHealth remains focused on investing in our care team and developing an inclusive environment where you can thrive and feel supported to realize your full potential. If you're looking to build a career in a place where people help one another deliver best-in-class care, apply today.

If you have questions about this role, please contact todd.nevins@mainehealth.org