Pharmacy Technician - Prior Authorization Specialist III

About Us:

Arizona Liver Health (ALH) is dedicated to driving high standards of care and advancing medical innovation through leading clinical trials, ensuring patient safety and regulatory compliance, and generating high-quality clinical data. Our network of multiphase, multitherapeutic research, standard of care, and VEN Centers sites is staffed by skilled providers, research, clinic, pharmacy, and patient outreach professionals. ALH operates state-of-the-art facilities and programs to meet the evolving needs of clinical research and overall patient treatment.

Job Summary:

The Pharmacy Technician - Prior Authorization Specialist III is a crucial part of the healthcare team to assist patients in providing specialized, complex medications for their liver disease and/or condition. This includes obtaining authorizations, navigating financial assistance options, and working with patients, payors, and pharmacies. The prior authorization specialist takes care of the prescription from the time it is ordered to ensuring the patient receives the medication(s). 

Schedule: Onsite in Mesa, AZ, Full-Time, 8am-5pm Monday-Friday

Compensation: $28-$35 per hour, depending on experience

Essential job functions/duties 

Reasonable accommodation may be made to enable individuals with disabilities to perform these essential functions.  

• Assure all PA requirements are complete.  
• Facilitate labs/immunization completion for patient payor compliance. 
• Interact professionally with patients, peers, and other outside vendors as required.  
• Train new pharmacy staff on organizational processes and compliance procedures 
• Manage pharmacy software for patient compliance with treatment.
• Supports comprehensive coordination of commercial, Medicaid and/or Medicare pharmacy services including intake and processing of pharmacy authorization requests.  
• Promotes and supports quality effectiveness of healthcare and Pharmacy Services within clinical setting  
• Evaluates, authorizes approval, and communicates decisions for pharmacy requests according to clinic process 
• Evaluates and authorizes approval of pharmacy requests received by telephone, facsimile, and/or other means using client clinical criteria  
• Maintains accurate and complete documentation of required information that meets risk management, regulatory, and accreditation requirements with minimal to no supervision 
• Process requests in compliance with various laws and CMS regulations and company policies and procedures 
• Communicates with payors, external pharmacies, patients, case managers, electronic PA platforms 
• Promotes effective communication, both internally and externally, to enhance effectiveness of medication therapy management services 
• Escalates requests to Nurse Case Manager when request requires extensive clinical review or denial 

Knowledge/Skills/Abilities Required 

• At least three (3) years of experience working Pharmacy Prior Authorizations required 
• Previous super-tech experience required 
• Proven experience with pharmacy operations 
• Prior experience assisting in preparing detailed policy and procedures for accrediting agencies. 
• Ability to work independently with very minimal day-to-day supervision 
• Excellent written, verbal, and interpersonal/patient-service communication skills required 
• Proficient in Microsoft Office including Outlook and Excel 
• Intermediate to expert-level data entry computer skills with high attention to detail 
• Bilingual (English/Spanish), preferred 
• Ability to multi-task between different platforms, programs 
• EMR or pharmacy software proficiency required 
• Good to expert-level knowledge of pharmacy insurance benefits required <