Pharmacy Technician II – Prior Authorization Specialist bei Virginia Garcia Memorial Health Center

Job Title:         Clinical Certified Pharmacy Technician II (CPhT II) – Prior Authorization Specialist

FLSA:             Hourly “Non-Exempt”

Pay Scale:        U-08

Base Salary:         $26.45/hr. ($55,023.28 if annualized)  

Bilingual:        Bilingual Required           

Representation:    Represented

Department:         Pharmacy

Reports to:         Clinical Pharmacy Services Manager

At Virginia Garcia Memorial Health Center, we honor all members of our community and acknowledge the dignity of each person we serve. Our purpose is to provide high quality, comprehensive primary health care to the communities of Washington and Yamhill counties with a special emphasis on migrant and seasonal farm workers and a view to removing barriers to health care. We strive to provide an environment that welcomes and values the people we employ and serve.

If you are unsure whether you meet all the required qualifications for this role but are interested and passionate about this potential position, we encourage you to apply.

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Job Summary:

The Certified Pharmacy Technician II (CPhT II) is responsible for facilitating and submitting prior authorization (PA) requests through the electronic health record (EHR) system. This role supports efficient and timely medication access by coordinating with providers, payers, and pharmacy staff. The CPhT II also assists with core pharmacy technician duties including prescription processing, medication preparation, inventory management, and providing excellent customer service. This position requires a strong understanding of pharmacy operations and the ability to work independently in a fast-paced environment.

Essential Duties & Responsibilities:

Prior Authorization Duties:

Initiate and submit electronic prior authorization (ePA) requests through the EHR and payer-specific platforms.

Collaborate with prescribers to gather necessary clinical documentation for PA submissions.

Track and follow up on pending PA requests to ensure timely resolution and prevent treatment delays.

Communicate PA status updates to pharmacists, providers, and patients.

Maintain accurate records of all PA activities in compliance with organizational policies and regulatory standards.

Identify trends or issues in PA processing and assist with developing solutions or workflow improvements.

Serve as a liaison between pharmacy, providers, patients, and payers to ensure the successful navigation of coverage barriers.

Analyze and interpret insurance formularies and step therapy protocols for commercial plans, Medicare Part D, and Medicaid.

Assist with benefits investigations and coordination of benefits (COB) when needed.

Maintain patient confidentiality and comply with HIPAA regulations.

Assist patients in applying for patient assistance programs (PAPs) offered by pharmaceutical manufacturers or foundations when PA route is not available. Document and track for accurate record keeping.

Pharmacy Technician Duties:

Assist pharmacists in processing, filling, and dispensing prescriptions accurately and efficiently.

Handle medication inventory: order, receive, and restock medications according to pharmacy procedures.  

Answer patient inquiries regarding prescription status, insurance coverage, PA processes, and other medication related inquiries.

Perform data entry and maintain patient profiles with accurate and up-to-date information.

Adhere to all applicable federal, state, and organizational regulations and policies.

Participate in quality improvement initiatives and training opportunities.

Provide general support within the pharmacy including prescription preparation, inventory management, medication reconciliation, and patient education under the supervision of a licensed pharmacist.

Provide pharmacy coverage support at other sites on a temporary, as needed basis.

Provide excellent patient-focused customer service.

Perform other duties as assigned to support the efficiency and effectiveness of pharmacy and clinical operations.

HIPAA Requirements:

The CPhT II – PA Specialist will have access to PHI in the course of their duties.  Applying the minimum necessary standard of HIPAA, the designated record sets to which this employee will have access include: the full medical record, the pharmacy patient chart, the demographic and scheduling information of the practice management systems and all information in the pharmacy management computer system including billing and insurance information, prescription files, and patient profiles.

Knowledge, Skills, and Abilities:  

Required:

High school diploma or equivalent.

Minimum of 2 years of experience as a pharmacy technician.

Current Certified Pharmacy Technician (CPhT) credential through PTCB or ICPT.

Current and active Certified Oregon Pharmacy Technician license in good standing.

This position requires a current and valid Basic Life Support Certification upon hire. Must maintain current certification with a recognized provider.

Demonstrated knowledge of formulary structures, step therapy protocols, and prior authorization processes across major payors (e.g., Medicare, Medicaid).

Proficiency in EHR systems (e.g., Epic, Willow).

Bilingual – English/Spanish

Preferred:

Experience working in an outpatient or ambulatory care setting.

Strong communication and problem-solving skills.

Prior exposure to the PA process

Prior exposure to patient assistance programs and pharmaceutical manufacturer support services.

Prior experience supporting underserved patient populations.

Behavioral Competencies  

Accountability - Role model VG’s mission, vision, and shared values

Customer-Focus - Listen to the voice of the customer and strive to delight them by exceeding their expectations

Teamwork - If someone needs help, help them

Initiative - Be innovative, apply fresh ideas, and continuously improve how you do your work

Confidentiality - Maintain strict confidentiality and respect the privacy of others

Ethical - Demonstrate integrity, honesty, and stewardship in all encounters at work

Respect - Demonstrate consideration and appreciation for co-workers and patients

Communication - Demonstrate the ability to convey thoughts and ideas as well as understand perspective of others

Physical Requirements:

Percentage of time spent  

Standing/Walking: up to 90%

Sitting: up to 90%

Reaching/stooping/bending: up to 30%

Must be able to lift/carry up to 30 lbs., less than 5% of time

Computer usage: up to 90%

Must be able to open and close prescription and patient vials: 50%

Must be able to read for extended periods: up to 90%

Working Environment/Physical Hazards:

Work in a well-lit, ventilated environment.

May be exposed to drug vapor or particles (powered antibiotics that are reconstituted for example).

Possible indirect exposure to blood borne pathogens; expected to observe infection control.

Exposure to potentially hazardous chemicals.

Office & Medical Equipment Used:

Computer

Telephone, fax, copier, scanner.

Cash register (all pharmacy employees required to have basic training).

Glucometers and point of care lab monitoring.

Electronic ordering device.

Equipment necessary to measure vitals (blood pressure cuff, scale, etc.).

Immunization: 
Staff members must meet immunization requirements as stated in VGMHC’s immunization policy and state and federal guidelines.

Job descriptions represent a general outline of the essential and major job duties, functions, and qualifications required. They cannot be all-inclusive and comprehensive due to the dynamic nature of work performed to accomplish VGMHC’s Mission.  

VGMHC is an Equal Opportunity Employer. No person is unlawfully excluded from consideration for employment because of race, color, religious creed, national origin, ancestry, sex, age, veteran status, marital status, or physical challenges. The policy applies not only to recruitment and hiring practices, but also includes fairness in placement, promotion, transfer, rate of pay, and termination.