Full employer posting
MaineHealth Corporate Professional - Clinical Req #: 96191
The Pharmacy Prior Authorization Technician is responsible for coordinating and processing prior authorizations (PAs) for prescription medications to ensure timely patient access to treatment. Working closely with providers, pharmacists, payers, and patients, the technician utilizes the EHR and payer portals to facilitate and document the PA process. This role is key to supporting the clinical team in minimizing treatment delays and improving medication access.
The role will initially focus on Specialty Medications in specific clinics but is expected to expand and change over time. Key
Review medication orders (especially specialty medications) needing prior authorization. Initiate and complete prior authorization requests through electronic portals (e.g., CoverMyMeds, Surescripts, payer websites). Communicate with insurance companies to gather coverage requirements and status updates.
Collaborate with providers and pharmacists to obtain necessary clinical documentation for PA submissions. Document PA status, approvals, denials, and follow-ups within Epic using SmartPhrases and encounters. Notify providers of PA outcomes and assist with alternative medication strategies when necessary.
Track and manage open prior authorizations to ensure timely resolution and refill coordination. Support clinic staff and patients by providing status updates or coverage information as allowed. Maintain up-to-date knowledge of payer formulary changes and authorization requirements.
Participate in continuous quality improvement and workflow optimization efforts. Required Minimum Knowledge, Skills, and Abilities (KSAs)
High school diploma or equivalent required. License/Certifications: Current or eligible for applicable state(s) license as a Pharmacy Technician. CPhT certification is required.
One year of experience as a licensed pharmacy technician. Additional Information MaineHealth is committed to fostering a supportive, inclusive environment where care team members can thrive while making a meaningful impact in the communities we serve across Maine and New Hampshire. We offer competitive benefits including paid parental leave, flexible work options, student loan assistance, professional development opportunities, and well-being resources—so you can grow your career while feeling supported both personally and professionally.
We recognize the value each team member brings to our organization. Any offer of employment will depend on qualifications such as skills, relevant experience, education, certifications, and other job-related factors. The base range is an estimate and does not reflect the full value of our total compensation package.
The pay range for this position is $21.97 to $29.28 per hour. Compensation for part-time positions is determined on a prorated basis consistent with the scheduled hours and applicable full-time equivalent (FTE). In addition to base pay, MaineHealth offers comprehensive benefits, recognition programs, career growth opportunities, and, where applicable, shift differentials or other incentives.
If you have questions about this role, please contact sharon.nightingale@mainehealth.org Hiring Scam Alert MaineHealth will never request financial information during the interview or pre-hiring process. All legitimate communications will come from an email address ending in @mainehealth.org. If you suspect fraudulent activity, please report it immediately to mhcareers@mainehealth.org.
Notice Regarding Maine Employer Surveillance Statute: Pursuant to Maine's Employer Surveillance Statute, prospective care team members are notified that MaineHealth may monitor, collect, record, review, or retain information related to the use of its systems, networks, applications, files, data, communications platforms (including notified recordings), smart badges, building access, company vehicle GPS data, business calls, and workplace security cameras.
Information collected may be used for legitimate business purposes, including security, safety, compliance, investigations, training, quality assurance, and operational management.
About the role
The Pharmacy Prior Authorization Technician is responsible for coordinating and processing prior authorizations (PAs) for prescription medications to ensure timely patient access to treatment. Working closely with providers, pharmacists, payers, and patients, the technician utilizes the EHR and payer portals to facilitate and document the PA process.