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REMOTE Pharmacist- PBM Pharmacist

RemoteWorker US
Orlando, FL Remote Full Time
POSTED ON 7/26/2024 CLOSED ON 8/24/2024

What are the responsibilities and job description for the REMOTE Pharmacist- PBM Pharmacist position at RemoteWorker US?

Job Description

Job Description

A-Line Staffing is now hiring REMOTE PBM Prior Authorization Pharmacist! The REMOTE PBM Prior Authorization Pharmacist would be working for a Fortune 500 company and has career growth potential. This would be full time / 40 hours per week.

REMOTE PBM Prior Authorization Pharmacist Compensation

  • Benefits are available to full-time employees after 90 days of employment and include health, optical, dental, life, and short-term disability insurance
  • A 401(k) with a company match is available for full-time employees with 1 year of service on our eligibility dates

REMOTE PBM Prior Authorization Pharmacist Highlights

  • This position is a contract assignment with potential to hire on permanently based upon attendance, performance, and business needs
  • The required availability for this position is (Shifts assigned after training)
    • 1. Tuesday-Saturday 8am-4:30pm CST
    • 2. Sunday-Thursday 8am-4:30pm CST
    • 3. Monday-Friday 9:30am-6pm CST
REMOTE PBM Prior Authorization Pharmacist Responsibilities

  • The clinical pharmacist is an operation-based role that conducts clinical reviews of medical data collected to perform prior authorization for specialty medications.
  • The clinical pharmacist will apply clinical knowledge to plan approved criteria for prospective and concurrent reviews of cases.
  • This role will work from supported systems and take inbound calls from physician or members regarding their pending approved or denied prior authorizations.
  • Collaborates with the CRU Technician to process referrals including answering clinical questions collecting appropriate clinical/ medical data needed to perform clinical assessments and reviews as per the healthplan/employer agreed criteria within the designated service level agreements.
  • Coordinates timely communication of case decision to physician health-plan/employer patient and other healthcare professionals following agreed upon approval denial management processes.
  • Handles inbound phone calls and escalations from physicians or patients regarding Prior Authorization.
  • Maintain professional and technical knowledge of drug and disease-states for the Specialty Pharmacy programs administered within the Case Review Unit

REMOTE PBM Prior Authorization Pharmacist Requirements

  • 1 year of recent experience with PBM prior authorization
  • Active and in good standing Pharmacist license in the state in which you sit
  • Attendance is mandatory for the first 90 days

If you think this REMOTE PBM Prior Authorization Pharmacist position is a good fit for you, please reach out to me - feel free to call, e-mail, or apply to this posting!
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