Pharmacist - Prior Authorizations

Job title: Pharmacist
Location : Remote
Duration: 6 Months (Possible Extension)
Must be licensed in the state of North Carolina. (Can reside in any state.)
Shift: Shift 11am to 730pm EST

Position Summary:

Evaluate and review all prior authorization requests and render coverage determinations based on clinical criteria and plan design. Includes verifying insurance coverage and eligibil ity, interpreting clinical guideline criteria, consulting physicians and other healthcare providers, and appropriately utilizing clinical knowledge and resources while complying with department protocols.

Duties:

• This position is a 100% remote, work from home opportunity and will not be patient facing.
• Demonstrated experience using clinical resources, e g., Micromedex, Lexicomp, Clinical Pharmacology
• Ability to prioritize, quickly assess, manage multiple tasks and adapt to constantly changing situations.
• Prior authorization, call center and/or clinical pharmacy experience.
  

Experience:

• Hold and maintain an active, unencumbered Pharmacist license in North Carolina.
• Position requires proficiency with computer skills which include multitasking, navigating multiple systems, and keyboarding. Experience using MS Office, other Windows based computer applications, web based processing and telephony programs.
• Minimum 2 years recent experience reviewing and processing prior authorizations aProductst health plan criteria for a determination in a specialty/skilled clinical setting i.e., specialty medical office or Pharmacy Benefits Manager (PBM)
  
  Education:
  Bachelor's degree in Pharmacy or PharmD