Job#: 3032209

Job Description:

Location: Fully Remote

Compensation: $18-20/hour

Duration: 6-month contract with strong possibility for extension

Schedule: Monday–Friday, 9 AM – 6 PM, 40 hours a week (ALL HOURS ARE EST)

*PLEASE LIST YOUR  CphT, PTCB and/or STATE REGISTRATION CLEARLY AT THE TOP OF YOUR RESUME*

Are you a detail-oriented pharmacy professional looking for a flexible, remote opportunity? Join our team and play a vital role in ensuring patients receive timely and accurate medication coverage. This position offers the chance to work from home while contributing to a mission-driven organization that values precision, compliance, and exceptional service.

• Track and triage coverage determination requests from providers.
• Determine if pharmacist review is required and obtain verbal authorizations.
• Request detailed clinical information from prescribers.
• Approve coverage determination requests based on defined criteria.
• Document decisions in the PBM system and notify providers and/or members.
• Respond to client inquiries regarding authorization approvals and PBM online applications.
• Refer specialty drug requests to delegated vendors or clients.
• Contact providers for additional information to facilitate reviews.
• Notify physicians, providers, and members of coverage determination decisions.

You will manage and process coverage determination requests for prior authorizations and Medicare Part D recipients, ensuring compliance and accuracy every step of the way.

• Education: High school diploma or equivalent.
• Experience: 1+ years in retail, hospital, or mail-order pharmacy.
• Licenses/Certifications:
  • Current state Pharmacy Technician license
  • National Certification from Pharmacy Technician Certification Board (CPhT)

• Fully remote work environment
• Competitive hourly pay
• Opportunity for contract extension
• Supportive team and structured training program

The pay rate for this position is between $18.00 and $20.00 per hour. A benefits package is available to eligible employees.

This employer is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against on the basis of disability.

Apex uses a virtual recruiter as part of the application process. Click here for more details.

If you have visited our website in search of information on employment opportunities or to apply for a position, and you require an accommodation in using our website for a search or application, please contact our Benefits Department at [email protected] or 804-523-8228.

Everforth Apex is a world-class IT services company that serves thousands of clients across the globe. When you join Everforth Apex, you become part of a team that values innovation, collaboration, and continuous learning. We offer quality career resources, training, certifications, development opportunities, and a comprehensive benefits package. Our commitment to excellence is reflected in many awards, including ClearlyRateds Best of Staffing® in Talent Satisfaction in the United States and Great Place to Work® in the United Kingdom and Mexico.

Everforth Apex uses a virtual recruiter as part of the application process. Click here for more details. By applying for this job, you agree to receive calls, AI-generated calls, text messages, or emails from Everforth Apex and its affiliates, and contracted partners. Frequency varies for text messages. Message and data rates may apply. Carriers are not liable for delayed or undelivered messages. You can reply STOP to cancel and HELP for help. You can access our privacy policy at https://www.apexsystems.com/privacy-policy

Everforth Apex Benefits Overview: Everforth Apex offers a range of supplemental benefits, including medical, dental, vision, life, disability, and other insurance plans that offer an optional layer of financial protection. We offer an ESPP (employee stock purchase program) and a 401K program which allows you to contribute typically within 30 days of starting, with a company match after 12 months of tenure. Everforth Apex also offers a HSA (Health Savings Account on the HDHP plan), a SupportLinc Employee Assistance Program (EAP) with up to 8 free counseling sessions, a corporate discount savings program and other discounts. In terms of professional development, Everforth Apex hosts an on-demand training program, provides access to certification prep and a library of technical and leadership courses/books/seminars once you have 6+ months of tenure, and certification discounts and other perks to associations that include CompTIA and IIBA. Everforth Apex has a dedicated customer service team for our Consultants that can address questions around benefits and other resources, as well as a certified Career Coach. You can access a full list of our benefits, programs, support teams and resources within our ‘Welcome Packet’ as well, which an Everforth Apex team member can provide.

Everforth Apex Systems is an equal opportunity employer. We do not discriminate or allow discrimination on the basis of race, color, religion, creed, sex (including pregnancy, childbirth, breastfeeding, or related medical conditions), age, sexual orientation, gender identity, national origin, ancestry, citizenship, genetic information, registered domestic partner status, marital status, disability, status as a crime victim, protected veteran status, political affiliation, union membership, or any other characteristic protected by law. Everforth Apex will consider qualified applicants with criminal histories in a manner consistent with the requirements of applicable law.

If you require an accommodation under the Americans with Disabilities Act to participate in an interview with a virtual recruiter or to use our website for a search or application, please contact our Benefits Department at [email protected] or 804-523-8228. Please note that this contact information is strictly to be used for medical ADA accommodations and that no other inquiries will be answered.

UnitedHealthcare creates and publishes the Transparency in Coverage Machine-Readable Files on behalf of Everforth Apex Systems.