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CVS Health

Runs pharmacies, health plans and clinics

Pharmacy Technician - Prior Authorization

Full-TimePosted on 10/21/2026Deadline 10/30/26
$18.50 - $35.29/hr+ Bonus + Commission + Short-term incentive
Mid, Senior
Arizona, USA
RemoteRemote work from Arizona; requires home internet of at least 100 Mbps and a secure home workspace.
Medical, Clinical & VeterinaryPharmacy
Company Historically Provides H1B Sponsorship

About the job

Requirements
  • A current, in-good-standing National Pharmacy Technician certification and Arizona or applicable-state Pharmacy Technician license are required and must be maintained.
  • Between 1 and 5+ years of Pharmacy Prior Authorization processing experience.
  • Ability to multitask and prioritize work.
  • Ability to adjust based on business or department needs.
  • Good organization skills.
  • High school diploma or GED.
  • Own home internet access with a minimum download speed of 100 Mbps; a wired Ethernet connection is acceptable.
  • A secure workspace or office in the candidate's home.
  • High-level PC skills, including using a mouse and keyboard and accessing and navigating multiple systems and screens.
  • Ability to work extended hours when necessary.
  • All full-time employees must work 40 scheduled hours per week, including weekends and holidays.
Responsibilities
  • Process prior-authorization requests received by phone, fax, or electronically, using computer resources, existing criteria, and medication guidelines to conduct clinical research supporting prior-authorization reviews.
  • Proactively complete prior-authorization approvals and denials due to expire, and maintain complete, timely, and accurate documentation.
  • Review potential prior-authorization denial language to ensure NCQA requirements are met.
  • Follow prior-authorization workflows, policies, and procedures during the workday.
  • Answer potentially high-volume prior-authorization inquiry calls from provider offices, pharmacies, and internal partners, using computer resources to communicate status or decisions.
  • Maintain a balance of productivity, quality, and timeliness.
  • Participate in required training, continuing education, and team or departmental meetings.
  • Work scheduled eight-hour shifts within operating hours of 5:00 a.m. to 7:00 p.m., which may vary by time zone; overnight shifts may be available but are not guaranteed, and schedules may change based on company needs.
  • Work a rotating weekend schedule if required.
Desired Qualifications
  • Retail or hospital experience.
  • Managed care or Medicaid experience.
  • AS400 experience.
  • Proficiency with computerized resources and software applications.
  • Proficiency with Microsoft Excel, Word, and Outlook.
  • Knowledge of pharmacy practices and procedures, and ability to read and understand clinical information.
  • Working knowledge of drug dosage forms, drug strength, and generic and brand-name equivalents.

About the company

CVS Health runs pharmacies, health insurance plans and medical clinics for individuals, employers and government programs across the United States. Its businesses include CVS Pharmacy, the Aetna insurer and Caremark, which manages prescription coverage and negotiates drug prices for health plans. Patients fill prescriptions in stores or by mail and receive care through walk-in clinics, primary care centers and home visits. The company earns money from prescription sales, insurance premiums, plan administration fees and clinical services, combining coverage with places to obtain treatment. Its first store opened in 1963, and its headquarters are in Woonsocket, Rhode Island.

Company Size

10,001+

Company Stage

IPO

Headquarters

Woonsocket, Rhode Island

Founded

1963

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Simplify's Take

What believers are saying

  • Demand is expanding: CVS Health reported $106.1 billion revenue in the June 2026 quarter, up 7.3% year over year.
  • Eligible colleagues get degree support: CVS Health's partner-college program covers tuition with no out-of-pocket cost through reimbursement.
  • Self-pay care is expanding: MinuteClinic announced $29 online weight-loss visits in August 2026, without recurring membership fees.

What critics are saying

  • Insurance leaves a narrow cushion: Aetna's medical costs consumed 87.4% of premium revenue in the June 2026 quarter.
  • Drug fees face limits: Caremark's July 2026 FTC settlement proposes separating fees from drug list prices.
  • Wilmington's pharmacist role includes mobility: CVS Rx Services lists up to 25% travel across nearby pharmacy locations.

What makes CVS Health unique

  • Its pharmacy shelves are tobacco-free: CVS removed tobacco products while keeping its national retail pharmacy network.
  • Caremark separates drug costs from service fees: TrueCost anchors pricing to acquisition benchmarks and makes dispensing fees visible.
  • Its clinics accept care-cost risk: Oak Street receives fixed payments from health plans rather than billing only per visit.

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Benefits

  • Health Insurance
  • Dental Insurance
  • Vision Insurance
  • Life Insurance
  • Disability Insurance
  • 401(k) Retirement Plan
  • Company Equity
  • Wellness Program
  • Professional Development Budget
  • Paid Vacation
  • Paid Holidays

Company News

Yahoo Finance
Oct 24th, 2026
CVS Health shares up 20.2% this year as bulls see $103 fair value and bears $62.09

CVS Health shareholders have gained 20.2% since the start of the year, including dividends, after the company launched its Health100 AI platform and quickly built out GLP-1 programmes. The shares cost $79.36 on January 1, 2026, and now trade at $93.47. Investors hold two views. Bulls set fair value at $103, assuming 18.0% revenue growth and a 2.0% profit margin. Bears put it at $62.09, assuming 7.0% growth, citing retail pressure and policy risk. Second-quarter 2026 revenue was $105.5 billion and net income $2.98 billion. Net margin reached 2.8%, up from 1.0% a year earlier, which supports the bulls, though lawsuits and regulatory settlements leave risks open.

Yahoo Finance
Oct 20th, 2026
CVS opens small 3,000 sq ft pharmacies to fill gaps left by 1,000 Walgreens and Rite Aid closures

CVS Health is opening small, pharmacy-only stores in communities left underserved after rivals closed locations. The chain has opened its newest 3,000-square-foot store in Roxbury, Massachusetts, just outside Boston. Walgreens and CVS have closed over 1,000 stores in recent years, and Rite Aid shut all 2,000 of its stores in 2023. Thinner margins strained profits at the chains. CVS plans to open 20 small-format stores this year. It already has sites in Birmingham, Chicago, Detroit, Houston, and Washington, D.C. Most offer immunisations as well as prescriptions. Smaller stores could cut inventory and rent costs. Walgreens has opened about 100 smaller stores for the same reason. IBISWorld puts the US pharmacy market at $739.4 billion in 2026.

PR Newswire
Oct 20th, 2026
MinuteClinic opens three Massachusetts clinics, including its first in Boston

CVS Health said MinuteClinic, its medical clinic inside select CVS Pharmacy stores, has opened three Massachusetts locations in Charlestown, Beverly, and Swampscott. The Charlestown clinic is the first MinuteClinic in Boston. Board-certified nurse practitioners staff each clinic. They offer vaccinations, health screenings, routine lab tests, physicals, and treatment for minor illnesses and injuries. Patients aged 18 months and older can walk in seven days a week, including evenings and weekends. Most major health insurance is accepted, and self-pay options are available. "By making care more accessible, we can help patients address health concerns earlier and avoid unnecessary visits to higher-cost settings such as the emergency room," said Tara Allain, executive area director at MinuteClinic.

Yahoo Finance
Oct 19th, 2026
CVS Health raises 2026 revenue forecast to $414B, but shares fall 11.5%

CVS Health raised its fiscal 2026 revenue forecast on August 5 to at least $414 billion, up from $405 billion in May. Yet the stock has fallen 11.5% since, against a 1.0% dip for the S&P 500. The company also lifted its adjusted earnings per share target to between $7.90 and $8.10, from $7.40 at the mid-point. It now expects cash flow from operations of at least $11.5 billion, up from $9.5 billion. Shares closed at $92.36 on October 16, just above the 50-day average of $91.73 and the 200-day average of $87.51. The new forecast implies second-half revenue about 0.5% below the same period last year. The next key test is the September quarter report, expected on November 4.

PR Newswire
Oct 7th, 2026
CVS Health opens first pharmacy-focused location in Boston area

CVS Health has opened its first pharmacy-focused location in the Boston area, situated at 32 Warren Street in Roxbury. The company plans to launch nearly 20 such locations across the US in 2026 to increase access to pharmacy care. The new format features full-service pharmacies averaging 3,000 square feet, offering prescription medications, immunisations, and over-the-counter products. Customers can order additional items with free home delivery. The Roxbury site includes a medication disposal bin and safe needle collection point. These smaller pharmacies complement CVS's existing formats, including traditional stores, store-in-store locations in Target and Schnucks, and sites with MinuteClinic facilities. According to CVS Health's 2025 Rx Report, 80% of patients prefer face-to-face pharmacy care, whilst 48% would switch pharmacies if limited to digital-only options.