Remote Prior Authorization Jobs in Raleigh, NC (NOW HIRING)

Description

Your passion belongs at UNC Health. Join more than 56,000 teammates working together to improve the health and well-being of the communities we serve across North Carolina.

Summary:

The Pharmacy Benefit Medication Assistance Program (MAP) Pharmacy Access and Solutions Technician supports medication access, utilization, and optimization. The Pharmacy Benefit MAP team is responsible for prior authorization support and financial assistance enrollment-including copay cards, grants, and manufacturer assistance-for outpatient prescriptions. The goal is to navigate payer coverage requirements and mitigate patient financial toxicity.

This role operates with a high level of autonomy, working directly with patients, prescribers, payers, and other members of the healthcare team in a remote, virtual setting. The technician also identifies and initiates process improvement efforts, with an emphasis on delivering high-quality patient care and customer service.

This position qualifies for our Pharmacy Technician Incentive Program, which includes $5000 in commitment incentives spread over a two-year period. Payment is made after six months, one year, and two years of employment. 

Responsibilities:

1. Maintain current knowledge of service line regulations and external support programs
2. Proactively identify and analyze opportunities for intervention; develop solutions to customer concerns both within and outside the department
3. Utilize internal systems, the electronic health record (Epic), and vendor platforms, including AI, to document and track patient eligibility, prescriptions, communications, and program enrollment
4. Document and communicate findings to patients, providers, and pharmacies in a timely and professional manner, in accordance with operational standards
5. Support the development and implementation of process improvements to enhance workflow efficiency, patient care, and clinical outcomes
6. Respond to and resolve pharmacy-related inquiries from members, clients, providers, and pharmacies; appropriately triage when additional expertise is needed
7. Participate in process improvement initiatives, including workflow reviews, documentation updates, and training/education as opportunities arise

Other information:
Education Requirements:
HS diploma or equivalent.
Licensure/Certification Requirements:
Registration with the NC Board of Pharmacy unless enrolled in a PharmD program.
CPhT from PTCB or ExCPT from NHA unless enrolled in a PharmD program.
Two years to obtain CPhT from PTCB or ExCPT from NHA if hired as a non -technician with qualified years of experience.
Professional Experience Requirements:
Two years of pharmacy technician experience required or three years of relevant experience in a related field.
Knowledge/Skills/and Abilities Requirements:

Legal Employer: NCHEALTH

Entity: Shared Services

Organization Unit: Amb. Pharm Care Network - MAP

Work Type: Full Time

Standard Hours Per Week: 40.00

Salary Range: $19.98 - $28.54 per hour (Hiring Range)

Pay offers are determined by experience and internal equity

Work Assignment Type: Remote

Work Schedule: Day Job

Location of Job: US:NC:Durham

Exempt From Overtime: Exempt: No

This position is employed by NC Health (Rex Healthcare, Inc., d/b/a NC Health), a private, fully-owned subsidiary of UNC Health Care System, in a department that provides shared services to operations across UNC Health Care; except that, if you are currently a UNCHCS State employee already working in a designated shared services department, you may remain a UNCHCS State employee if selected for this job.

Qualified applicants will be considered without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, genetic information, disability, status as a protected veteran or political affiliation.
UNC Health makes reasonable accommodations for applicants' and employees' religious practices and beliefs, as well as applicants and employees with disabilities. All interested applicants are invited to apply for career opportunities. Please email applicant.accommodations@unchealth.unc.edu if you need a reasonable accommodation to search and/or to apply for a career opportunity.