Note: The job is a remote job and is open to candidates in USA. Prescryptive is a healthcare technology company enabling direct access to prescription drugs through its platform. The Contract Clinical Services Support Technician will maintain clinical drug lists, prior authorization documents, quantity limit rules, and benefit configurations while resolving related questions. The role also involves preparing reports and client-facing clinical materials, coordinating with internal stakeholders, and improving processes through technology and automation.
Responsibilities
- Synchronize Medispan drug lists in drug list management platform
- Update prior authorization (PA) coverage criteria documents with formulary updates and client customizations
- Maintain quantity limit (QL) rules and complete downstream client-specific changes
- Investigate claim rejections related to drug list platform configuration and resolve clinical drug list and benefit setup questions. Escalate issues requiring clinical review
- Prepare and publish coverage policies files and printed client drug lists under clinical quality assurance review
- Establish quality control checkpoints for PA updates, QL cleanup, and PA printing, with pharmacist or clinical team review before finalization
- Analyze, generate, and distribute medication lists and reports, and prepare client-facing clinical materials, including disruption analyses for annual and quarterly business reviews
- Coordinate with pharmacists, operational teams, and other internal stakeholders to meet deadlines
- Identify opportunities to improve accuracy and efficiency through technology, automation, and AI-enabled tools
Skills
- High school diploma or equivalent and active Certified Pharmacy Technician (CPhT) certification through PTCB or ExCPT, with state registration or licensure where required
- 3 years of pharmacy technician experience
- 2 years of experience at a pharmacy benefit manager (PBM) supporting clinical services, such as utilization management, coverage review, or prior authorization resolution
- Demonstrated experience with mail order and specialty pharmacy operations, prior authorization support, formularies, drug lists, and National Drug Code (NDC) identifiers
- Hands-on experience with formulary or drug information databases and PBM platforms
- Strong Microsoft Excel and PowerPoint skills to compare drug list data and prepare reports and presentations
- Attention to detail and accuracy in maintaining claims adjudication data and preparing client-facing materials, including disruption analyses, benefit summaries, and business review presentations
- Strong follow-through and clear written and verbal communication to coordinate with pharmacists, Operations teams, and internal stakeholders and meet deadlines in a high-volume environment
- Sound judgment about what you can resolve independently and when pharmacist review is needed
- Motivation to learn and grow, with openness to technology, automation, and AI-enabled tools
- Experience directly maintaining formularies or drug lists, updating prior authorization criteria, and configuring coverage or benefits
- Experience with Managed Markets Insight & Technology (MMIT) platform and Medispan
- Experience using RxLogic for pharmacy benefit administration or claims processing
Benefits
- Remote (U.S.-based)
- Prescryptive will provide a laptop for the duration of the contract.
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