Job Listing ID:

4548384

Job Title:

Clinical Pharmacy Technician Sr - Medi-Cal Rx (Remote California)

Application Deadline:

Open Until Filled

Job Location:

Salem

Date Posted:

08/14/2026

Hours Worked Per Week:

Not Provided

Shift:

Not Provided

Duration of Job:

Either Full or Part Time, more than 6 months SR You may contact this employer directly. (Obtain the contact information to print or add to your jobs.) Obtain Contact Information Job Summary Home Full time R-17231 At Prime Therapeutics (Prime), we are a different kind of PBM, with a purpose beyond profits and a unique ability to connect care for those we serve. Looking for a purpose-driven career? Come build the future of pharmacy with us. Job Posting Title Clinical Pharmacy Technician Sr - Medi-Cal Rx (Remote California) Job Description The Senior Clinical Pharmacy Technician - Medi-Cal independently manages prior authorization requests, eligibility, pharmacy benefits, and claims using established clinical criteria. This role serves as a technical resource to team members, supports resolution of non-routine cases, and identifies opportunities to improve workflow efficiency. Responsibilities Independently review, research, and resolve prior authorization requests by applying clinical criteria, established guidelines, and professional judgment within defined protocols Communicate coverage determinations, formulary alternatives, and prior authorization requirements to providers and internal stakeholders, ensuring clarity and accuracy in non-routine scenarios Manage inbound and outbound inquiries related to eligibility, benefits, claims, and prior authorizations, resolving moderately complex issues and determining appropriate next steps Escalate clinically complex or exception-based cases to a pharmacist, providing thorough documentation and relevant case context to support timely resolution Educate providers and members on claims submission processes, appeals requirements, and reimbursement guidelines across multiple networks Initiates, prioritize, and manage cases by accurately gathering and entering member and provider information Identify trends, root causes, high-risk inquiries, and workflow gaps in daily operations and recommend process improvements to enhance efficiency, quality, and consistency Serve as a resource to team members by providing guidance, answering process questions, and supporting onboarding activities Other duties as assigned Minimum Qualifications High school diploma from an accredited school or equivalent GED 2 years of work experience as a pharmacy technician Licensed Pharmacy Technician in accordance with California state requirements Must be eligible to work in the United States without the need for work visa or residency sponsorship Additional Qualifications Strong knowledge of pharmacy workflows, terminology, and reimbursement processes Ability to prioritize work and manage multiple assignments in a dynamic environment Effective communication skills with the ability to guide and support team members Proficiency in pharmacy systems and Microsoft Office applications Preferred Qualifications 1 year reimbursement experience PBM or health care experience Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their job, and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures Every employee must be able to perform the essential functions of the job and, if requested, reasonable accommodations will be made to enable employees with disabilities to perform the essential functions, absent undue hardship. In addition, Prime retains the right to change or assign other duties to this job Potential pay for this position ranges from $19.23 - $28.85 based on experience and skills. To review our Benefits, Incentives and Additional Compensation, visit our Benefits Page ( Medical Records Specialists Access our Statewide and Regional occupation report for more information about wages, employment outlooks, skills, training programs, related occupations, and more. Compensation Not Provided Job Requirements

Experience Required:

See Job Summary

Education Required:

None

Minimum Age:

N/A