Duties & Responsibilities:Reviews prior authorization requests and units for medications requested under the medical benefitAssesses provider-submitted clinical information for clinical appropriateness based on predetermined clinical criteriaSends notification to members and providers of authorization decisions via telephone, fax, or mailEnsures prior authorization reviews are conducted within timeframes set forth by CMS and/or NYSDOHEstablishes great rapport with Provider offices via telephonic communicationSends request for information sheets to ProvidersEnsures that patient information is shared appropriately maintaining confidentiality and compliance with federal law and HIPAA regulationsAdditional duties as necessaryMinimum Qualifications:High School Diploma or GED from an accredited institutionEither nationally certified Pharmacy Technician in good standing (i.e., PTCB, NHA) or registered or licensed Pharmacy Technician in good standingExperience conducting prior authorization reviewsExperience requiring written, verbal, and telephonic communication in English that is clear, concise, grammatically correct, and professionalPreferred Qualifications:Strong written and verbal communication skills in Chinese, Spanish, or RussianDemonstrated critical thinking and problem-solving skillsTeam player with a passion for learning and interest in growing skills in a dynamic environment with various opportunitiesKnowledge of specialty pharmaceuticals and billing practices in the medical benefitKnowledge of regulations of the Centers for Medicare and Medicaid Services including but not limited to National and LocalCoverage DeterminationsPC Skills with Microsoft Word, PowerPoint (creating presentations and slides), and Excel (Pivot tables).Experience with TruCare Care Management PlatformCompliance & Regulatory Responsibilities: Noted aboveLicense/Certification: Nationally certified Pharmacy Technician in good standing (i.e., PTCB, NHA) or registered or a licensed Pharmacy Technician in good standing. They establish rapport with Provider offices and leverages strong communication and customer service skills when providing updates and delivering decision notifications to members and providers, The UM Pharmacy Technician position is part of multidisciplinary team and works closely with Providers, Pharmacists, and Medical Directors.