Highmark Health · 3 months ago
Clinical Pharmacy Technician II
Pittsburgh PA, 15224, West Penn 4800 Friendship Ave
Full-time
Onsite
Entry, Mid Level
2+ years expHighmark Health is part of Allegheny Health Network, seeking a Clinical Pharmacy Technician II. This role focuses on pharmacy benefits coordination, insurance evaluations, and patient access procedures, ensuring efficient processing and compliance with regulatory standards.
Health CareHospital
Responsibilities
Prior Authorization & Utilization Management: Reviews pharmacy utilization management (UM) coverage requests for both pharmacy and medical benefits and prepares such cases for clinical review when required. Within the context of the request, applies plan-specific benefits to each case appropriately, summarizes pertinent facts, and cites applicable internal policies and guidelines. (40%)
Patient & Provider Coordination: Resolves non-clinical issues independently and acts as a liaison between customers, provider-facing teams, and the Pharmacy Department. Engages in member and provider outreach to resolve issues such as appeal initiation requests, processing errors, and fulfilling notification requirements. Schedules appointments, verifies patient information, and addresses inquiries. Performs referral screening and processing, coordinating with specialists and ensuring timely patient access to necessary services. (30%)
Data Management & Compliance: Responsible for all preauthorization entries into applicable databases (i.e., internal medical claims systems, PBM pharmacy systems) to ensure swift and appropriate payment of services deemed medically necessary. Conducts insurance evaluations to determine patient eligibility and coverage for services. Performs medication reconciliation tasks to ensure accurate medication lists and prevent potential drug interactions. Maintains regulatory compliance and resolves all cases within predetermined timeframes. Assists patients with applications to access affordable medications. (30%)
Other duties as assigned or requested
Qualification
Required
2 years of experience as a Pharmacy Technician, Patient Access Coordinator, or Medical Assistant in health care setting
Preferred
Associate degree
Certified Pharmacy Technician (CPhT) from Pharmacy Technician Certification Board
Company
Highmark Health
Highmark Health is an integrated health care delivery and financing network.
10001+ employees
H1B Sponsorship
Highmark Health has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (38)
2024 (34)
2023 (55)
2022 (75)
2021 (54)
2020 (58)
Funding
Current Stage
Late StageTotal Funding
$6.75MKey Investors
Henry L. Hillman FoundationRichard King Mellon Foundation
2025-06-11Grant· $1.75M
2021-05-10Grant· $5M
Leadership Team
David Holmberg
President and Chief Executive Officer
Karen Hanlon
Executive Vice President, Chief Operating Officer
Recent News
Seattle TechFlash
2025-12-29
Company data provided by crunchbase