Job Description

Job Description

\n Kelly® is looking for a Pharmacy Prior Authorization Technician to work at a top insurance client in the Rochester, NY area. Let us help you grow at work and discover the next step in your career, all while being a vital part of your community
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\n Location: Rochester, NY
\n Pay Rate: $22.00/hour
\n Hours:  M-F 8am to 5pm - Schedule: Required to work every other weekend beginning no later than January 2026
\n \n \n Summary Description \nThe Pharmacy Prior Authorization Technician performs initial-level processing and review of prior authorization requests for both pharmacy and medical specialty drug reviews as permitted by law. Reviews are conducted in accordance with pharmacy management drug policies and procedures. Responsibilities include preparing and interpreting cases for Utilization Management (UM) reviews and acting as a content expert for applications used to process these requests. The Technician serves as a resource for staff on members’ contract benefits, related health plan functions, and provides leadership in the intake area of the prior authorization process.\n\n \n Essential Responsibilities/Accountabilities \n\n

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• Conduct initial medication prior-authorization, exception, and medical necessity reviews\n\t
• Route cases to pharmacist/medical director for final determination, as directed\n\t
• Issue verbal and written notifications to members as required\n\t
• Review and interpret prescription and medical benefit coverage (including Medicare D); document necessary information for clinical staff\n\t
• Develop and implement process improvements for efficiency\n\t
• Collaborate with providers, clinical pharmacists, and internal staff on coverage determinations\n\t
• Identify nuances regarding requests and clarify prior authorization information\n\t
• Communicate with pharmacies/physician offices for clarification on requests and claims\n\t
• Act as lead troubleshooter for pharmacy help desk, customer care, and claims processors\n\t
• Assure proper authorization entry; perform manual system manipulation as needed\n\t
• Participate in system testing for upgrades/enhancements\n\t
• Serve as content expert and liaison for prior authorization intake and claims systems interface\n\t
• Triage daily workflow, monitor queues, monitor compliance deadlines, and communicate with management\n\t
• Provide phone support for UM process, offering friendly, accurate, timely assistance\n\t
• Support drug pricing inquiries using online tools and resources\n\t
• Maintain thorough knowledge of health plan contract information and assist colleagues\n\t
• Perform workflow processes in line with policies, guidelines, and regulations\n\t
• Track and report department performance against benchmarks\n\t
• Prepare and handle correspondence accurately and timely\n\t
• Coordinate with other departments for consistent service delivery\n\t
• Meet team average in medication prior-authorization and review completions\n\t
• Demonstrate integrity, support company mission/values, and adhere to Corporate Code of Conduct\n\t
• Ensure privacy of member information\n\t
• Maintain regular, reliable attendance\n\t
• Perform other assigned functions\n

\n\n \n Minimum Resource Qualifications \n\n

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• High school diploma required with at least 2 years’ experience in a health-related field; Associate’s degree preferred\n\t
• Pharmacy Technician certification (CPhT), LPN, or Medical Assistant/Technologist background strongly preferred\n

\n\n \n Physical Requirements \n\n

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• Ability to work prolonged periods sitting at a workstation and using a computer, keyboard, mouse, and phone\n\t
• Ability to work in a remote home office environment\n\t
• Ability to travel regionally as needed for meetings/training\n\t
• Clear verbal communication abilities\n

\n What happens next: \n\n

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• Once you apply, you’ll proceed to next steps if your skills and experience look like a good fit. But don’t worry—even if this position doesn’t work out, you’re still in our network.\n\t
• That means all of our recruiters will have access to your profile, expanding your opportunities even more.\n

\nHelping you discover what’s next in your career is what we’re all about, so let’s get to work.
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\n Apply to be a Pharmacy Prior Authorization Technician today!

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\n\t\t\t\tAs part of our promise to talent, Kelly supports those who work with us through a variety of benefits, perks, and work-related resources. Kelly offers eligible employees voluntary benefit plans including medical, dental, vision, telemedicine, term life, whole life, accident insurance, critical illness, a legal plan, and short-term disability. As a Kelly employee, you will have access to a retirement savings plan, service bonus and holiday pay plans (earn up to eight paid holidays per benefit year), and a transit spending account. In addition, employees are entitled to earn paid sick leave under the applicable state or local plan. Click here for more information on benefits and perks that may be available to you as a member of the Kelly Talent Community.

Get a complete career fit with Kelly®.

You’re looking to keep your career moving onward and upward, and we’re here to help you do just that. Our staffing experts connect you with top companies for opportunities where you can learn, grow, and thrive. Jobs that fit your skills and experience, and most importantly, fit right on your path of where you want to go in your career. \n\t\t\t \n\t\t\t

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About Kelly

Work changes everything. And at Kelly, we’re obsessed with where it can take you. To us, it’s about more than simply accepting your next job opportunity. It’s the fuel that powers every next step of your life. It’s the ripple effect that changes and improves everything for your family, your community, and the world. Which is why, here at Kelly, we are dedicated to providing you with limitless opportunities to enrich your life—just ask the 300,000 people we employ each year.

Kelly is committed to providing equal employment opportunities to all qualified employees and applicants regardless of race, color, sex, sexual orientation, gender identity, religion, national origin, disability, veteran status, age, marital status, pregnancy, genetic information, or any other legally protected status, and we take affirmative action to recruit, employ, and advance qualified individuals with disabilities and protected veterans in the workforce. Requests for accommodation related to our application process can be directed to the Kelly Human Resource Knowledge Center. Kelly complies with the requirements of California’s state and local Fair Chance laws. A conviction does not automatically bar individuals from employment. Kelly participates in E-Verify and will provide the federal government with your Form I-9 information to confirm that you are authorized to work in the U.S. \n\t\t\t \n\t\t\t

Job Tags

Contract work, Temporary work, Local area, Remote work, Work from home, Home office, Weekend work,

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