Work From Home Drug Utilization Review (DUR) Technician
Job Summary CVS Health is seeking a dedicated Drug Utilization Review (DUR) Technician to join our growing remote pharmacy operations team. In this role, you will play a critical part in ensuring patient safety and medication effectiveness through accurate evaluation and analysis of prescription drug use. You will support pharmacists in conducting utilization reviews, verifying prescription claims, identifying potential drug interactions, and promoting compliance with clinical guidelines and regulatory standards. This position is ideal for certified pharmacy technicians who are detail-oriented, organized, and passionate about improving patient outcomes—all from the comfort of their home.
Key Responsibilities
- *
Review prescription and medical claims data to identify medication therapy issues, potential drug interactions, and inappropriate prescribing patterns.
- *
Support clinical pharmacists in evaluating drug utilization trends and ensuring compliance with formulary and clinical guidelines.
- *
Process prior authorization requests and assist in case documentation according to company and regulatory requirements.
- *
Communicate with healthcare providers, pharmacies, and insurance representatives to gather or clarify information as needed.
- *
Maintain accurate and detailed records of drug reviews, interventions, and follow-up actions in pharmacy systems.
- *
Collaborate with the clinical and claims team to improve workflow efficiency and ensure accurate data management.
- *
Uphold CVS Healths quality and compliance standards while maintaining patient confidentiality in all communications.
- Required Skills and Qualifications
- *
Certified Pharmacy Technician (CPhT) with active state certification and registration.
- *
Strong understanding of prescription drug terminology, dosage forms, and therapeutic classes.
- *
Proficient in data entry, electronic health records (EHR), and pharmacy information systems.
- *
Excellent communication skills (written and verbal) with strong attention to accuracy and detail.
- *
Ability to work independently and manage multiple cases in a remote work environment.
- *
Basic knowledge of drug utilization review (DUR) processes and insurance claim adjudication.
- Experience
- *
Minimum of 1–3 years of experience as a pharmacy technician in a retail, mail order, or managed care environment.
- *
Previous experience in drug utilization review, clinical support, or prior authorization preferred.
- Working Hours
- *
Flexible remote schedule with options for both full-time and part-time shifts.
- *
Availability during standard business hours (Monday–Friday) with occasional weekend or evening coverage as required.
- *
Must have a reliable internet connection and a quiet home workspace.
- Knowledge, Skills, and Abilities
- *
In-depth understanding of pharmacy benefit management and formulary guidelines.
- *
Ability to interpret medical terminology and drug interaction reports.
- *
Proficiency in Microsoft Office Suite and pharmacy management systems.
- *
Strong analytical and problem-solving skills with a focus on accuracy and timeliness.
- *
Commitment to maintaining confidentiality and adhering to HIPAA regulations.
- *
Self-motivated, disciplined, and able to perform efficiently in a virtual team setting.
- Benefits
- *
Competitive salary with performance-based incentives.
- *
Comprehensive health, dental, and vision insurance.
- *
Paid time off, holidays, and employee wellness programs.
- *
401(k) retirement savings plan with company match.
- *
Employee discounts on CVS Health products and services.
- *
Opportunities for professional development and internal career growth.
- Why Join CVS Health
At CVS Health, we are committed to transforming healthcare by delivering better experiences and outcomes for our patients and communities. As part of our pharmacy operations team, you will be joining a culture built on innovation, collaboration, and compassion. Working remotely allows you to balance your career and personal life while contributing to a mission that truly makes a difference in peoples health and well-being.
How to Apply
Interested candidates are encouraged to apply online through the official CVS Health Careers Portal. Submit your updated resume, highlighting relevant pharmacy experience and certification details. Qualified applicants will be contacted by our recruitment team for further assessment and interview scheduling.