Pharmacist

Job Description

Job Summary:

• The Pharmacist/Clinician is an operation-based role that conducts criteria based & clinical review of medical data collected to perform prior authorization as per policy and procedure.
• The Pharmacist/Clinician will apply clinical knowledge to plan approved criteria for reviews of cases.
• This role will work from Client Client supported systems and take inbound calls from physicians or members regarding their pending, approved, or denied prior authorizations, internally support the Prior Auth team and member services department, as well as provide on-call after hours availability for urgent PA request as needed.

Education:

• Required: Bachelor’s Degree – BS Pharmacy and an active pharmacist license in the state of practice/residence.
• Preferred: Doctorate – Pharm D
• Active Pharmacist License.

Skills & Experience:

• Previous pharmacy experience in PBM preferred.
• Appropriate state license required.
• Basic computer skills required.
• Strong organizational skill, interpersonal skills and detail orientation important for this position.
• Required: 1 to 3 years.
• Preferred: 3 to 5 years.
• Internet Speed Test Screenshot.
• Computer Proficiency Assessment (free online assessment to be completed on basic computer skills).
• Candidate questionnaire must be completed.