[Remote] Clinical Pharmacist Reviwer- REMOTE

Note: The job is a remote job and is open to candidates in USA. Prime Therapeutics is a unique pharmacy benefit manager focused on connecting care for those they serve. They are seeking a Clinical Pharmacist Reviewer responsible for processing and documenting Utilization Management requests and collaborating with healthcare providers on clinical product coverage issues.ResponsibilitiesProcess the clinical evaluation for coverage determination requests for prior authorization (PA) or other utilization management (UM) programs, including quantity limits, step therapy, formulary exception and tier exception; this includes consideration of the denial language and appropriateness of the decision as it pertains to the clinical content of the case and the intent of the individual client’s pre-approved criteriaConsult directly with healthcare providers to address non-formulary and clinical product coverage issuesCollaborate with team members to ensure consistent decision-making across the pharmacist teamRespond to medication-related inquiries via phone, providing accurate information to patients, providers, and clinics regarding medications, formulary options, and coverage questionsOther duties as assignedSkillsDoctor of Pharmacy (PharmD) or Bachelor of Science Pharmacy Degree1 years of work experience in clinical, retail, hospital, or managed careCurrent pharmacist license in good standing with the State Board of PharmacyMust be eligible to work in the United States without the need for work visa or residency sponsorshipStrong verbal and written communication skillsAbility to work efficiently with computers and digital toolsManaged care experienceCompany OverviewPrime Therapeutics is a trusted pharmacy solutions partner delivering savings, simplicity & support to our customers and members It was founded in 1990, and is headquartered in Eagan, Minnesota, USA, with a workforce of 5001-10000 employees. Its website is https://www.primetherapeutics.com/.



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