Join a company that’s reimagining healthcare through smarter technology. In this role, you’ll apply clinical knowledge to evaluate coverage determinations, working closely with pharmacists, doctors, and beneficiaries while ensuring compliance with federal regulations.
About Abarca Health
Abarca Health is transforming the pharmacy benefit management industry with innovation, bold thinking, and technology that puts people first. The company values diversity, equity, inclusion, and belonging, creating a workplace where team members thrive while making a real difference in healthcare.
Schedule
- Temporary 6-month contract
- Remote role with Pacific Time Zone hours (9 AM – 6 PM)
- Must be available for rotating shifts, including evenings, weekends, and holidays
- Hybrid schedule may apply for candidates in Puerto Rico
What You’ll Do
- Review and respond to coverage determination (CD) requests for Medicare, Medicaid, and commercial plans
- Communicate with physicians, pharmacies, and members to gather information and resolve requests
- Generate calls, faxes, and letters regarding CD case outcomes
- Document all actions in compliance with CMS and company policies
- Support pharmacists in evaluating exceptions and special requests
What You Need
- Associate’s degree in Pharmacy Technician (or equivalent experience)
- 3+ years of customer service experience
- Strong Microsoft Office skills (Outlook, Excel, Word, PowerPoint)
- Excellent written and verbal communication skills in English
- Availability to work on-call hours, nights, weekends, and holidays as required
Nice to Have
- Certified Pharmacy Technician license
- Prior experience in healthcare or pharmacy
Benefits
- Competitive pay
- Flexible hybrid model (for Puerto Rico-based candidates)
- Inclusive, diverse, and supportive workplace culture
This is your chance to contribute to a healthcare company that’s driving bold change in pharmacy benefits.
Apply now and help Abarca redefine what’s possible.
Happy Hunting,
~Two Chicks…