Certified Pharmacy Technician - Remote US
About The Position
Join Gainwell as a Certified Pharmacy Technician (CPhT) supporting Rhode Island Medicaid and other state pharmacy programs. In this fully remote role, you will support pharmacy claims, prior authorization, provider support, eligibility, formulary, and program operations. You will work with state agency personnel, providers, pharmacies, and internal teams to research and resolve pharmacy-related issues and support accurate program administration. The role is suited to an experienced Certified Pharmacy Technician with managed care, PBM, health plan, or pharmacy-benefit experience who can serve as a pharmacy program resource. The position is full-time, non-exempt, and remote within the United States. The schedule is Monday through Friday, 8:00 a.m.–5:00 p.m. Eastern Time. Frequent interaction with state agency personnel, members, providers, pharmacies, pharmacy technicians, leadership, and internal stakeholders is expected. A reliable high-speed internet connection and professional, distraction-free home workspace are required.
Requirements
- Active Certified Pharmacy Technician credential (PTCB/CPhT, ExCPT, or equivalent).
- Two or more years of relevant pharmacy technician experience.
- Experience with pharmacy prior authorizations, prescription claims, medication terminology, and member, provider, or pharmacy support.
- Strong communication, research, problem-solving, computer, and organizational skills, with the ability to navigate multiple systems in a fast-paced remote environment.
- Reliable high-speed internet and a professional, distraction-free home workspace.
Nice To Haves
- Relevant experience within managed care, health insurance, PBM, pharmacy benefits, Medicaid, or a related healthcare environment.
- Experience with POS claims, HCPCS, provider enrollment, formularies, eligibility, or related pharmacy program operations.
Responsibilities
- Maintain day-to-day relationships with state agency personnel while supporting eligibility updates, reporting, formulary activities, and prior authorization support.
- Support state agency pharmacy programs, policies, processes, and reporting requirements, including POS and HCPCS adjudication related to medication prior authorizations.
- Review, research, and process pharmacy prior authorization requests in accordance with established criteria, policies, regulatory requirements, FDA guidance, and service-level expectations.
- Research and resolve program, member, provider, and pharmacy inquiries, including provider enrollment questions involving limited distribution drugs, while documenting activity accurately.
- Partner with internal departments on pharmacy initiatives, provide pharmacy program subject-matter expertise, and help identify opportunities to improve quality and operational performance.
Benefits
- Medical, dental, and vision benefits for eligible employees, subject to applicable eligibility guidelines.
- 401(k) options for eligible employees, subject to applicable eligibility guidelines.
- 401(k) employer match for eligible full-time candidates.
- Flexible vacation policy for eligible salaried, full-time candidates.
- Educational assistance.
- Leadership and technical development academies.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
