Clinical Prior Authorization Pharmacist

Remote Full-time
This a Full Remote job, the offer is available from: Connecticut (USA) Duration: 3+ months Contract (Can get Extended) Job Profile Summary: The Prior Authorization (PA) Pharmacist is responsible for reviewing prior authorization requests from providers to ensure safe and effective medication utilization. The PA pharmacist will work with internal and external stakeholders in evaluating and continually developing a strategy for Utilization Management. Essential Job Functions: β€’ Review Prior Authorization requests from medical professionals to ensure alignment with Preferred Drug List (PDL) criteria and current clinical guidelines. β€’ Support Peer to Peer discussions with medical providers to discuss Prior Authorization reviews β€’ Collaborates on the refinement of consultation scripting; solicits and utilizes input from those contacted toward scripting improvements. β€’ Contributes to the success of the Clinical Call Centers and Prior Authorization department by assisting with the implementation and management of both written and verbal communications to members and physicians. Is available for consultation on pharmacy-related questions and issues for others within the organization. β€’ Upholds clinical integrity of pharmaceutical solutions by staying up to date on medication information, clinical guidelines, contributing to the identification of pharmacy program best practices, and collaborating with Medical Directors, Clinical Pharmacist, and Clinical Pharmacist to provide pharmacy expertise. β€’ Collaborate internally with pharmacy team (Pharmacy Manager, PDL Coordinator, Clinical Pharmacists) to identify trends or areas to explore with the intent of identifying new drugs and therapeutic classes needing utilization management. Requirements: β€’ PharmD or B.S. in Pharmacy with relevant Specialty background. β€’ Registered Pharmacist with unrestricted respective State Licensure (Connecticut Pharmacist License Preferred but not required). β€’ 4 years’ experience in clinical pharmacy. β€’ Strong verbal and written communications skills. β€’ Highly skilled with Microsoft Office products and ability to quickly learn proprietary systems. Basic Qualifications: β€’ Experience in the coordination of and collaboration of work teams preferred. β€’ Ability to perform clinical reviews using relevant compendia and clinical trial data. β€’ Managed care and/or prior authorization experience a plus. β€’ Strong research and implementation skills in practical settings. β€’ Analytical skills which can translate into practical and pragmatic recommendations. β€’ Strong team orientation with respect for all members. About US Tech Solutions: US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions. To know more about US Tech Solutions, please visit www.ustechsolutions.com. US Tech Solutions is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, colour, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. Internal ID: 26-07878 #LI-BP1 This offer from "US Tech Solutions" has been enriched by Jobgether.com and got a 72% flex score.
Apply Now

Similar Opportunities

Experienced Registered Behavior Technician for In-Home ABA Therapy - Atlanta, GA

Remote Full-time

Immediate Hiring: Experienced Registered Behavioral Technician (RBT) for Clinic-Based ABA Therapy Services

Remote Full-time

Experienced Registered Behavioral Technician (RBT) - ABA Therapy for Children with Autism Spectrum Disorder

Remote Full-time

Experienced Registered Nurse - Telehealth: Providing Remote Care Coordination and Patient Support

Remote Full-time

Experienced Substitute Teacher for Riverside County Schools - Join Scoot Education's Innovative Team

Remote Full-time

Experienced Substitute Teacher for San Bernardino County - Flexible Schedules & Competitive Pay

Remote Full-time

Experienced School Year Instructional Coach for High-Dosage Tutoring Programs in Edgewater Park, NJ

Remote Full-time

Experienced School Year Tutor for K-8 Students in Math and Literacy - Mickleton, NJ

Remote Full-time

Experienced Secondary Social Studies Teacher for Kansas - Flexible Hybrid Remote Arrangement

Remote Full-time

USPS Office Helper

Remote Full-time

HEDIS Medical Record Collector - Remote

Remote Full-time

**Experienced Customer Service Representative/Data Entry Specialist – Remote Opportunity at arenaflex**

Remote Full-time

FULL TIME Netflix From Home Watching Movies@ La…

Remote Full-time

**Experienced Customer Service Representative – Repair and Warranty Coordination Specialist at blithequark**

Remote Full-time

Integration Engineer (US Citizenship Required) US - Tucson, AZ

Remote Full-time

**Experienced Data Entry Specialist – Remote Work Opportunity with arenaflex**

Remote Full-time

Infection Control Nurse

Remote Full-time

**Experienced Licensed Customer Service Representative – Unlock Your Potential with arenaflex**

Remote Full-time

**Experienced Customer Service Representative – Remote Part-time Opportunities at blithequark**

Remote Full-time

Principal Consultant - Telecom

Remote Full-time
← Back to Home