Role Description
Join Gainwell as a Certified Senior Pharmacy Technician and play an important role in supporting pharmacy benefit operations and delivering quality service to members, providers, and pharmacies. In this fully remote role, you will serve as a pharmacy subject matter resource, process and research prior authorization requests, resolve escalated pharmacy inquiries, and support pharmacy technicians through training and coaching. This opportunity is ideal for an experienced Certified Pharmacy Technician who thrives in a fast-paced healthcare environment and enjoys combining pharmacy knowledge with customer service and problem-solving.
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Review, research, and process pharmacy prior authorization requests in accordance with established criteria, policies, regulatory requirements, and service-level agreements.
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Research and resolve member, provider, and pharmacy inquiries and escalations while providing accurate information and appropriate follow-up.
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Accurately document calls, authorization activity, inquiries, and resolutions while maintaining compliance with HIPAA, PHI, and applicable program requirements.
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Serve as a subject matter resource and support new-hire training, continuing education, coaching, and development of pharmacy technician team members.
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Monitor quality and operational trends, identify opportunities for improvement, and collaborate with supervisors and leadership to support service, productivity, and quality goals.
Qualifications
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Active Certified Pharmacy Technician credential (PTCB/CPhT, ExCPT, or equivalent) required.
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Two (2) or more years of relevant pharmacy technician experience, preferably within managed care, health insurance, PBM, pharmacy benefits, or a related healthcare environment.
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Experience with pharmacy prior authorizations, prescription claims, medication terminology, and member, provider, or pharmacy support.
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Experience training, coaching, mentoring, or serving as a subject matter resource for pharmacy technicians or healthcare operations staff preferred.
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Strong communication, research, problem-solving, computer, and organizational skills with the ability to navigate multiple systems and work effectively in a fast-paced remote environment.
Requirements
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Full-time, non-exempt, 100% remote/work-from-home position for candidates residing within the United States.
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Monday through Friday work environment; 8am-4:30pm EST or 9am-5:30pm EST.
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Frequent interaction with members, providers, pharmacies, pharmacy technicians, leadership, and other internal stakeholders while independently managing assigned responsibilities.
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Reliable high-speed internet and a professional, distraction-free home workspace are required to effectively perform remote responsibilities.
Benefits
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Eligible employees have access to Gainwell benefits, including medical, dental and vision coverage, a 401(k)-retirement savings plan, paid time off, and additional wellness and financial programs, subject to applicable eligibility requirements.
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Generous, flexible vacation policy.
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401(k) employer match.
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Comprehensive health benefits.
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Educational assistance.
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Variety of leadership and technical development academies to help build your skills and capabilities.