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Irwindale, CACity of Hope is an independent biomedical research and treatment center for cancer, diabetes and other life-threatening diseases.
Founded in 1913, City of Hope is a leader in bone marrow transplantation and immunotherapy such as CAR T cell therapy. City of Hope’s translational research and personalized treatment protocols advance care throughout the world. Human synthetic insulin, monoclonal antibodies and numerous breakthrough cancer drugs are based on technology developed at the institution. AccessHope™, a wholly owned subsidiary, was launched in 2019 and is dedicated to serving employers and their health care partners by providing access to City of Hope’s exceptional cancer expertise.
A National Cancer Institute-designated comprehensive cancer center and a founding member of the National Comprehensive Cancer Network, City of Hope is ranked among the nation’s “Best Hospitals” in cancer by U.S. News & World Report and received Magnet Recognition from the American Nurses Credentialing Center. Its main campus is located near Los Angeles, with additional locations throughout Southern California and in Arizona.
Pharmacy Prior Authorization Technician-Foundation
Join the transformative team at City of Hope, where we're changing lives and making a real difference in the fight against cancer, diabetes, and other life-threatening illnesses. City of Hope’s growing national system includes its Los Angeles campus, a network of clinical care locations across Southern California, a new cancer center in Orange County, California, and treatment facilities in Atlanta, Chicago and Phoenix. our dedicated and compassionate employees are driven by a common mission: To deliver the cures of tomorrow to the people who need them today.
The Prior Authorization (PA) Technician plays a key role in assisting the clinical review pharmacist with daily tasks. Their responsibilities include collecting clinical information and documentation needed for approving oncology and specialty medical injectables. The technician conducts preliminary treatment reviews, identifies key requirements based on payor guidelines, and ensures accurate HCPCS codes and unit details through quality assurance checks. Additionally, they assist with authorization or payment denials by coordinating payor peer-to-peer reviews and gathering necessary information to support denial appeals.
As a successful candidate, you will:
- Ability to operate proficiently within the EPIC EHR System.
- Create/update/modify treatment referral shell.
- Navigate through patient chart and treatment plan to extract pertinent clinical information.
- Navigate through various payor authorization portals and identify payor treatment requirements.
- Serve as a clinic liaison with clinic pharmacy and medical staff regarding authorization related questions.
- Support clinical review pharmacist with tracking authorization and payment denial status.
- Conducts quality assurance review of referral shell inputs authorization shells.
- Communicates effectively with all levels of staff.
Your qualifications should include:
- High School or experience may substitute for minimum education
- Three years of performing pharmacy related duties
- Licensed as a Pharmacy Technician with the California State Board
- PTCB certification, preferred
- Experience working in a health plan, medical group, or pharmacy benefit manager Pharmacy infusion experience, preferred
City of Hope employees pay is based on the following criteria: work experience, qualifications, and work location.
City of Hope is an equal opportunity employer. To learn more about our commitment to diversity, equity, and inclusion, please click here.
To learn more about our Comprehensive Benefits, please CLICK HERE.