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Great companies need great teams to propel their operations. Join the group that solves business challenges and enhances the way we work and grow. Working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values your contributions and puts a premium on work flexibility, learning, and career development.
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.
The pay range for this position is $33,500 - $47,900 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. Put your passion to work at Gainwell. You’ll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits, and educational assistance. We also have a variety of leadership and technical development academies to help build your skills and capabilities.
We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Build your career with Gainwell, an industry leader. You’ll be joining a company where collaboration, innovation, and inclusion fuel our growth. Learn more about Gainwell at our company website and visit our Careers site for all available job role openings.
Gainwell Technologies is an Equal Opportunity Employer, where all qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical condition), age, sexual orientation, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. Gainwell Technologies defines “wages” and “wage rates” to include “all forms of pay, including, but not limited to, salary, overtime pay, bonuses, stock, stock options, profit sharing and bonus plans, life insurance, vacation and holiday pay, cleaning or gasoline allowances, hotel accommodations, reimbursement for travel expenses, and benefits.
