Remote Optum Prior Authorization Jobs (NOW HIRING)

Job Title: Remote Pharmacy Technician (prior authorization review)

Job Description

As a Remote Prior Authorization Review Pharmacy Technician, you will perform duties in various areas including Formulary Management, Pharmacy Audit and Recovery, Pharmacy Service Center, Medicare Part D/Part B, Appeals, Medicare Part D Operations, and State Health Programs Pharmacy Operations. You will review requests made by physicians, medical groups, pharmacies, and members for the use of prescription drugs and pharmacy benefits. Your role involves researching and resolving questions, problems, or issues and consulting with Clinical Pharmacists or Regional Medical Directors as needed.

Responsibilities

• Train on Intake and Technician Review processes.

• Accurately type information on the prior authorization request form into a Compass case.

• Verify intake accuracy and compare prior authorization requests with clinical documentation to determine approval.

• Contact the office for any missing information required for request approval.

• Route denials to the pharmacist queue for double-checking.

• Remediate cases if determinations need overturning or errors need correction.

• Move cases to the Manual Outreach queue and communicate decisions to providers and/or members.

Essential Skills

• Pharmacy Technician license.

• 2 years of experience as a Pharmacy Technician.

• Experience with managed care and claims.

• Proficiency in data entry.

Additional Skills & Qualifications

• Customer service or retail experience preferred.

• Familiarity with Microsoft functions including Teams, Outlook, Word, Excel, and OneNote.

Work Environment

This position is fully remote, fostering a strong sense of connectivity and support through Teams for chat, audio or video calls, and screen shares. Outlook is heavily used for team communications. The training schedule is Monday-Friday from 10am to 6:30pm. Post-training, the schedule will be Tuesday-Friday from 12:30pm to 9pm EST and Saturday from 8am to 4:30pm EST. Overtime is not expected.

Job Type & Location

This is a Contract to Hire position based out of Louisville, KY.

Pay and Benefits

The pay range for this position is $18.00 - $22.00/hr.

Eligibility requirements apply to some benefits and may depend on your job 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 Aug 12, 2026.

FOR THIS TYPE OF EMPLOYMENT STATE LAW REQUIRES A CRIMINAL RECORD CHECK AS A CONDITION OF EMPLOYMENT.

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 20,000 consultants and 5,000 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500. We are proud to be an Engineering News-Record (ENR) Top 500 Design Firm for our engineering design services and a ClearlyRated Best of Staffing® winner for both client and talent service.

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 process due to a disability, please email actalentaccommodation@actalentservices.com for other accommodation options.

San Francisco Fair Chance Ordinance: Pursuant to the San Francisco Fair Chance Ordinance, for all positions located in the city and county of San Francisco, we will consider for employment qualified applicants with arrest and conviction records.

Massachusetts Lie Detector: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.

Use of Artificial Intelligence (AI): We may use Artificial Intelligence (AI) to support parts of our hiring process, including sourcing, screening, and evaluating candidates. AI helps assess applications and qualifications, but final decisions are made by our hiring team. By applying, you acknowledge and agree that your application may be reviewed using AI tools.