Judi Health
Healthcare
UtilizationManagementTechnician(TemptoHire)
“Utilization Management Technician (Temp to Hire) at Judi Health. Skills: Utilization Management, Prior Authorization, Pharmacy Technician. Prepare prior authorization requests received by validating prescriber and member information, level of review, and appropriate clinical guidelines. Make outbound calls to providers to obtain additional clinical information to ensure substantial clinical information exists to reach a clinical determination for pharmacist review”
Industry & Context.
What They're Looking For.
Must Have
2+ years of pharmacy technician experience in a PBM, health plan, or in another clinical pharmacy setting, Experience handling prior authorization requests/understanding of prior authorization requirements required, National Certified Pharmacy Technician (CPhT) license, required
Nice to Have
Associate’s or bachelor’s degree is preferred
What You'll Do.
Prepare prior authorization requests received by validating prescriber and member information
and appropriate clinical guidelines
Make outbound calls to providers to obtain additional clinical information to ensure substantial clinical information exists to reach a clinical determination for pharmacist review
Proactively obtains clinical information from prescribers
referral coordinators
and appropriate staff to ensure all aspects of clinical guidelines are addressed for pharmacist review.
Review and analyze pharmacy claims data for proactive outreach and intervention.
and escalate provider concerns to the appropriate internal team including various members of the Prior Authorization Team
Triage phone calls from members
and providers by asking applicable drug and client specific clinical questions.
How You'll Work.
Team & Collaboration
collaborate in a team with shifting priorities; escalate provider concerns to the appropriate internal team; communicate issues and resolutions to ... appropriate internal stakeholders
Communication Scope
Excellent communication, writing, and organizational skills; Effectively communicate issues and resolutions to members, pharmacy staff, providers, and appropriate internal stakeholders.
Applying for this Utilization Management Technician (Temp to Hire) role?
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- Answer all knockout questions carefully — wrong answers auto-reject before a human sees you.
- Enable email notifications to track application status in real time.
ANONYMOUS · UNFILTERED
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