Pharmacist - Prior Authorization - Remote
Remote Pharmacist openings with a Major Corporation! Don't miss out on these great opportunities to work from home. FULLY REMOTE - Must have Prior Authorization experience! (Looking for it outside of Retail Setting)
We have Different openings with different shifts: WE ARE LOOKING FOR FLEXIBILITY!
1 Position has Shifts available for SUNDAY-THURSDAY or TUESDAY-SATURDAY - will work one weekend day per week basically and the 3 shifts are: 10:30am-7pm CST 11am-7:30pm CST or 11:30am-8pm CST
1 Position is MONDAY - FRIDAY - 930am - 6pm Local time
Start Dates in September, October, November and more!
Title - Pharmacist- Prior Authorization
Pay - 53.00 per hour pending experience
Description - The position will perform clinical review of prior authorization requests, coordinate the distribution of clinical drug information, and educate providers and staff regarding the appropriate use of pharmaceutical treatment regimens. In addition, the position will support the clinical pharmacy team, supporting quality initiatives as well as other projects as needed by the line of business.
Performs clinical review of prior authorization requests. Utilizes clinical experience and skills in a collaborative process to apply the appropriate clinical criteria/guideline, policy, procedure and clinical judgment to render appropriate coverage determination. Monitors prescribing habits of participating physicians. Makes recommendations to physicians to improve medication regimens as appropriate.
Improves quality of service to members by developing programs to provide optimal pharmacy care to patients, participating in dispute resolution of drug utilization review, measuring and documenting improvements in patient care, and/or improving claim adjudication for proper provider reimbursement.
Acts as "subject matter expert" for clinical pharmacy issues (i.e., appeal, fraud, cognitive services, drug reviews, and education). Consults and lends expertise to other internal and external constituents in the coordination and administration of the utilization/benefit management function. Educates providers and staff regarding the appropriate use of pharmaceutical treatment regimens. May develop and maintain training documents for staff development.
Performs other duties as required
This is a WFH position for candidates with a strong clinical/technical knowledge base and independent problem-solving skills. Pharmacist can have an RPh or Pharm.D degree
Must have active license in state you reside in!
Jared Petrill /Please apply now! - We will have openings for September, October and November start dates!
Apply Job!