Prior Authorization Pharmacy Technician

Oscar

Prior Authorization Pharmacy Technician focusing on pharmacy decision-making and support for prior authorization issues at Oscar Health. Remote role with specific US state residency requirements.

Posted 5/12/2026full-timeRemote • Alabama, Arizona, Colorado, Connecticut, District of Columbia, Florida, Idaho, Illinois, Iowa, Kansas, Kentucky, Maine, Maryland, Massachusetts, Minnesota, Missouri, Montana, Nevada, New Hampshire, New Jersey, New Mexico, North Carolina, Ohio, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, Vermont, Virginia • 🇺🇸 United StatesJuniorMid-Level💰 $17 - $23 per hourWebsite

About the role

Key responsibilities & impact

Use Oscar and vendor tools to determine eligibility, screen for required documents, create, process, and properly track pharmacy prior authorization requests
Prepare, organize, and distribute pharmacy prior authorization requests for review by pharmacist/physician and respond to pharmacist/physician requests for additional information
Collect relevant medical information (via telephone, fax, and portal) and apply the appropriate PA criteria, clearly documenting all communication and decision making
Meet required decision-making timeframes, including promptly triggering escalation for cases requiring pharmacist review
Communicate oral and written prior authorization outcome notifications that comply with standards and requirements for content and accuracy
Compliance with all applicable laws and regulations
Other duties as assigned

Requirements

What you’ll need

2+ years of work experience in a pharmacy related field in a retail or managed care plan setting and/or prior authorization experience
Active, unrestricted Pharmacy Technician certification (CPhT)
Excellent customer service, phone etiquette, and typing skills

Benefits

Comp & perks

Health insurance
401(k) plan participation
Paid vacation accrual at a rate of 15 days per year
Paid sick time
Paid parental leave
Life and disability insurance
Paid wellness time and reimbursements

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

prior authorizationdocument trackingmedical information collectiondecision makingcompliance

Soft Skills

customer servicephone etiquettecommunicationorganization

Certifications

Pharmacy Technician certificationCPhT