Senior Certified Pharmacy Technician - Remote US

Summary

As a Senior Certified Pharmacy Technician in Gainwell’s Pharmacy Benefits Management (PBM) Clinical and Technical Call Center, you’ll serve as a subject matter expert supporting members, medical providers, and pharmacy providers with complex pharmacy benefit questions and medication access needs.

You’ll use your advanced pharmacy knowledge and PBM experience to resolve complex inquiries, support escalated issues, assist team members, and help ensure accurate and timely service across multiple communication channels, including phone, fax, email, and web-based platforms.

Your role in our mission

• Provide advanced support to members, prescribers, and pharmacy providers through phone, fax, email, and web-based communication channels.
• Research and resolve complex pharmacy benefit inquiries, including pharmacy claims, claim rejections, formulary questions, benefit interpretation, and medication access issues.
• Support and coordinate prior authorization processes and help ensure pharmacy-related requests are handled accurately and within established guidelines.
• Serve as a subject matter expert for team members by assisting with escalated issues, sharing pharmacy and PBM knowledge, and supporting training and onboarding activities.
• Contribute to quality and process improvement initiatives while meeting established service, productivity, compliance, and customer experience standards.

What we're looking for

• Active and current Certified Pharmacy Technician (CPhT) credential.
• Minimum of 2 years of call center experience, preferably in a healthcare or PBM environment.
• Minimum of 2 years of PBM experience, including knowledge of formulary management, pharmacy claims adjudication, and benefit interpretation.
• Strong knowledge of pharmacy claims processing and claim rejection resolution, with experience supporting or coordinating prior authorization decisions.
• Strong verbal and written communication skills, computer proficiency, attention to detail, and the ability to work across multiple systems in a fast-paced, high-volume environment.

Previous leadership experience, retail pharmacy or PBM call center experience, familiarity with pharmacy management systems, and bilingual skills are preferred.

What you should expect in this role

• This is a 100% remote position requiring a reliable high-speed internet connection and a private, quiet workspace suitable for handling confidential information.
• Candidates must comply with company technology, information security, and HIPAA requirements while using company-provided equipment.
• Must successfully complete required virtual onboarding and training and be comfortable with extended computer and headset use in a call center environment.
• Must be available to work assigned shifts based on business needs. Schedules may include first, second, or third shift, including evenings, overnights, weekends, or holidays.
• Candidates must complete a skills and competency assessment before advancing to the next stage of the selection process.

Candidates must reside in an approved state for remote employment as defined by company policy.

This position is being posted for pipeline purposes, and we welcome applications on an ongoing basis.

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