Job Description
Job Description
Department: Pharmacy Services
Status: Full-Time, Non-Exempt | Temporary (4+ Months)
Location: Hybrid
Travel: None
Salary: $21.00 - $26.00
"Our purpose is strong, our impact is lasting, join us on the journey"
Western Health Advantage
Support High-Quality, Compliant Pharmacy Care at the Health Plan Level
Western Health Advantage is seeking a Pharmacy Technician for a temporary assignment of 4+ months to support pharmacy utilization management and ensure timely, compliant, and accurate review of prescription medication requests. In this role, you will work closely with the Chief Pharmacy Officer, Pharmacy Manager, Medical Directors, Clinical Pharmacists, and Pharmacy Coordinator to help deliver high-quality pharmacy services across the health plan.
This temporary opportunity is ideal for an experienced Pharmacy Technician who enjoys working in a managed care environment, collaborating across departments, and making an immediate impact while supporting critical operational and regulatory needs.
What You’ll Do
As a Pharmacy Technician, you will support pharmacy utilization management and administrative functions critical to regulatory compliance and member care. Your responsibilities will include:
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Reviewing prescription medication authorization requests using established protocols and escalating non-standard clinical cases to Clinical Pharmacists
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Coordinating with internal teams to ensure timely, compliant authorization decisions and notifications to members and providers
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Assisting internal staff with interpretation of pharmacy benefits and authorization criteria
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Researching and preparing cases for Pharmacy leadership, Clinical Pharmacists, and/or the Chief Medical Officer, including drafting approval and denial letters
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Supporting maintenance of the WHA Formulary Drug List and Pharmacy Prior Authorization criteria based on P&T Committee decisions
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Assisting with regulatory, accreditation, pharmacy, and PBM audits (e.g., DMHC, NCQA)
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Ensuring accurate and timely processing of denial letters and related correspondence
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Maintaining current knowledge of medications and drug classifications
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Supporting administrative functions, including provider/member notifications and returned mail processing
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Assisting in the development and maintenance of pharmacy policies, procedures, and training materials
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Collaborating with Pharmacy leadership to ensure coverage meets regulatory turnaround requirements
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Mentoring and supporting less experienced Pharmacy Technicians and Pharmacy Coordinators, as applicable
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Supporting pharmacy-related Appeals and Grievances and completing special projects as assigned
What We’re Looking For
We’re seeking a detail-oriented Pharmacy Technician with managed care experience, strong communication skills, and a commitment to regulatory compliance and service excellence.
Required Qualifications
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High School Diploma or equivalent
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Minimum of 3 years of experience as a Pharmacy Technician
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At least 2 years of experience working in a utilization management or managed care environment
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Valid California Pharmacy Technician License in good standing (must be maintained throughout employment)
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Experience writing in a professional, business correspondence style
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Intermediate computer skills, including email, database activity, word processing, spreadsheets, and graphics
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Strong written and verbal communication skills
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Ability to read, write, speak, and understand the primary language(s) used in the workplace
Preferred Qualifications
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At least 1 year of experience in a customer service or call center environment
Why Join Western Health Advantage?
At Western Health Advantage, our Pharmacy team plays a vital role in ensuring safe, effective, and compliant medication access for our members. This temporary assignment offers an opportunity to contribute immediately, work with experienced clinical and pharmacy leaders, and gain valuable managed care experience within a mission-driven organization.
Physical Requirements
This role is primarily office-based with minimal physical demands. While performing job duties, the employee may occasionally stand, walk, sit, reach, or use hands to handle objects. The employee may occasionally lift or move up to 10 pounds. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the role.
Western Health Advantage is committed to providing equal employment opportunities to employees and applicants for employment on the basis of merit and without regard to race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, physical or mental disability, medical condition, genetic information, marital status, ancestry, military or veteran status, or any other basis made unlawful by federal or state law.
Western Health Advantage values and supports the unique talents and strengths that each employee brings to our organization. Collaborating with the best and the brightest means a dynamic, fulfilling work experience for you — and excellent customer service for our members.
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