Responsibilities
- Manage the intake of prior authorizations and set up PAs in the system.
- Send cases to the review tech after initial setup.
- Conduct tech reviews by evaluating PA cases received from the intake team.
- Read and analyze criteria, SOPs, insurance documents, and medical documents to determine eligibility.
- Make clinical determinations regarding medication approval, denial, or coverage.
Essential Skills
- Experience in data entry and pharmacy operations.
- Pharmacy Technician Certification.
- Experience with managed care and claims processing.
- Prior Authorization expertise.
- Strong customer service skills.
- Proficiency in computer skills and the ability to work remotely and independently.
Additional Skills & Qualifications
- Managed care experience.
- Pharmacy experience.
- Ability to handle customer service calls effectively, including controlling and redirecting conversations as needed.
- Cpht certification.
classification and length of employment. Benefits are subject to change and may be
subject to specific elections, plan, or program terms. If eligible, the benefits
available for this temporary role may include the following: Medical, dental & vision
Critical Illness, Accident, and Hospital
401(k) Retirement Plan Pre-tax and Roth post-tax contributions available
Life Insurance (Voluntary Life & AD&D for the employee and dependents)
Short and long-term disability
Health Spending Account (HSA)
Transportation benefits
Employee Assistance Program
Time Off/Leave (PTO, Vacation or Sick Leave) Workplace Type This is a fully remote position. Application Deadline This position is anticipated to close on Nov 23, 2025. About Actalent
Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500.
The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing due to a disability, please email ... for other accommodation options.