Pharmacy Technician - Prior Authorization Specialist (39897)

Community Health Care is a leading non-profit organization that offers quality health care to underserved patients in Pierce County. We provide comprehensive family practice care, including medical, dental, pharmacy, and behavioral health services in our seven clinics. We seek to continuously improve our commitment and service to our patients and community. We want you to join us in our mission to provide the highest quality healthcare with compassionate and accessible service for all

Requirements

• Accurately enter non-clinical and structured clinical data into Nextgen and other applications
• Document all PA outcomes approvals or denials
• Complete PA requests within established client turnaround times
• Review medication formularies and evaluate tried-and-failed alternatives
• Follow defined guidelines separating PA processing and clinical decisions
• Research and resolve PA issues using phone and written inquiries to providers, pharmacies, members, or SMEs
• Coordinate notifications and follow-up regarding pending requests and PA determinations
• Make outbound calls to update or obtain PA information
• Partner with clinical teams on PA requirements and special projects
• Provide staff support during high-volume PA periods
• Maintain PA and member confidentiality; ensure proper document handling
• Establish strong rapport with colleagues, providers, clients, and patients
• Contribute to Quality Assurance Improvement initiatives
• Serve as SME and mentor for nurses and provider teams
• Ensure provider access to managed-care formularies
• Troubleshoot PA issues and educate staff on compliance
• Act as Pharmacy Technician backup as needed
• Perform other duties as assigned

Benefits

• Medical
• Dental
• Paid Vacation
• Sick Leave
• 12 Paid Holidays
• Life Insurance
• Flexible Spending Account
• Continuing Education
• Employee Assistant Program