Job Description

As a Remote Prior Authorization Pharmacist, you will play a vital role in ensuring our patients receive the medications they need. You will collaborate with various teams to address clinical inquiries, gather essential clinical and medical data for thorough assessments, and conduct reviews in accordance with agreed-upon criteria from health plans and employers.

Key Responsibilities:

Collaboration and Communication (20%)
Work closely with clinical teams to provide timely responses to clinical questions and collect necessary medical data for comprehensive assessments. You'll help ensure our reviews meet the designated service level agreements.

Case Coordination (20%)
Effectively communicate case decisions to physicians, health plans, employers, patients, and other healthcare professionals. You'll be instrumental in following the approval and denial management processes to ensure everyone is informed.

Clinical Decision-Making (50%)
Review ongoing cases and make informed clinical decisions regarding Prior Authorizations, Tier Exceptions, and Non-Formulary requests, contributing significantly to patient care and treatment continuity.

Additional Duties (10%)
Participate in related projects and be available for on-call and after-hours support as needed, ensuring that our pharmacy services remain responsive and efficient.

Qualifications:

Proficiency in Microsoft Access, PowerPoint, and Visio is preferred.
Strong computer skills, including experience with Excel and Word.
A valid Registered Pharmacist license in your state of residence.
A minimum of 1 year of pharmacy experience is required, with 2-5 years preferred.
Benefits:

As a full-time employee, you'll enjoy a comprehensive benefits package available after 90 days of employment. This includes health, optical, dental, life, and short-term disability insurance. Additionally, you will have access to a 401(k) plan with a company match after one year of service.
Employment Type: Full-Time
Salary: $ 51.00 Per Hour

Job Tags

Hourly pay, Full time, Temporary work, Remote job,

Similar Jobs