Remote Pharmacist - Prior Authorization | PBM

Get It Recruit - Healthcare • Remote (Woonsocket, RI, US) • 3d ago

Job Overview

Join our dedicated team as a Remote Prior Authorization Pharmacist, where your expertise will be pivotal in ensuring that patients access the medications they require. In this role, you will collaborate with diverse clinical teams to address inquiries, compile essential clinical and medical data, and conduct reviews aligned with the criteria set forth by health plans and employers.

Key Responsibilities

Collaborate with clinical teams to deliver prompt responses to clinical inquiries and gather necessary medical information for comprehensive assessments, ensuring compliance with service level agreements.
Communicate case determinations effectively to physicians, health plans, employers, patients, and other healthcare professionals, facilitating a clear understanding of approval and denial processes.
Review ongoing cases, making informed clinical decisions regarding Prior Authorizations, Tier Exceptions, and Non-Formulary requests, which are crucial to maintaining patient care and treatment continuity.
Engage in related projects and provide on-call support and after-hours assistance when required, ensuring responsive and efficient pharmacy services.

Required Skills

Proficiency in Microsoft Access, PowerPoint, and Visio is preferred.
Strong computer skills, particularly in Excel and Word.
Exceptional communication and collaboration abilities.
Capability to make informed clinical decisions based on assessed data.

Qualifications

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.

Career Growth Opportunities

We are committed to fostering your professional development, providing access to ongoing training and advancement opportunities that will enhance your clinical skills and knowledge within the organization.

Company Culture And Values

Our organization thrives on a collaborative culture where teamwork and effective communication are paramount. We prioritize responsiveness and efficiency, ensuring that our pharmacy services effectively meet the needs of our patients and healthcare partners.

Compensation And Benefits

As a full-time employee, you will be eligible for a comprehensive benefits package after 90 days of employment, which 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