Help patients access the medications they need by supporting prior authorization reviews with accuracy and compassion.
About CVS Health
CVS Health is the nation’s leading health solutions company, serving millions of Americans through local presence, digital innovation, and more than 300,000 colleagues. As part of Aetna Pharmacy Prior Authorization, you’ll play a critical role in making sure patients receive timely, safe, and effective access to their prescribed treatments.
Schedule
- Full-time, 40 hours per week
- Hours of operation: 5:00 AM – 7:00 PM (may vary by time zone)
- 8-hour shifts within operating hours; rotating weekends required
- Overnight shifts may be available but not guaranteed
- Must be able to work weekends and holidays when needed
Responsibilities
- Process prior authorization requests received by phone, fax, or electronically.
- Utilize clinical criteria, medication guidelines, and computer systems to complete approvals or denials.
- Maintain accurate documentation that meets NCQA requirements.
- Proactively review expiring prior authorizations and manage renewals.
- Answer high-volume calls from providers, pharmacies, and internal partners, communicating status and decisions.
- Balance productivity, quality, and timeliness in all work.
- Participate in training, continuing education, and team meetings as required.
Requirements
- National Pharmacy Technician certification and applicable state license (current and in good standing).
- 1–5+ years of experience processing Pharmacy Prior Authorizations.
- Strong multitasking, prioritization, and organizational skills.
- High proficiency with PC systems and ability to navigate multiple applications.
- Must have home internet speed of at least 100 Mbps download and a HIPAA-compliant workspace.
Preferred Qualifications
- Retail or hospital pharmacy experience.
- Managed care or Medicaid background.
- AS400 experience.
- Proficiency with Microsoft Office (Excel, Word, Outlook).
- Knowledge of pharmacy practices, dosage forms, and brand/generic equivalents.
Benefits
- Pay range: $18.50 – $38.82/hour (based on experience and geography).
- Eligible for CVS Health bonus, commission, or short-term incentives.
- Medical, dental, and vision insurance.
- 401(k) with company match and employee stock purchase plan.
- Paid time off, flexible schedules, family leave, and dependent care resources.
- Tuition assistance, retiree medical access, and career development programs.
- No-cost wellness screenings, counseling, and financial coaching.
Join a team that values accuracy, empathy, and innovation in supporting patients and providers.
Happy Hunting,
~Two Chicks…