Remote PBM Pharmacist for Prior Authorization | WFH

Job Overview

We are in search of a committed Prior Authorization Pharmacist to join our esteemed team in a remote capacity. In this pivotal role, you will ensure the efficient handling of prior authorization requests in alignment with our organizational policies and procedures. Your professional expertise will enhance our operational workflows while delivering outstanding support to our clients.

Key Responsibilities

• Review and evaluate prior authorization requests, ensuring compliance with necessary criteria in accordance with our established protocols.
• Act as the decisive authority for all prior authorization denials.
• Respond promptly to incoming calls, giving priority to the ‘Pharmacist’ line and escalated inquiries, demonstrating exceptional communication skills in client support.
• Maintain precise documentation of all interactions and procedural steps, guaranteeing that records remain current and accessible.
• Address client exceptions with diligence, managing any unique situations with care and consideration.
• Ensure that all reference materials remain updated and accurate, positively contributing to the team’s overall efficiency.
• Process and maintain all prior authorization paperwork in line with organizational standards.
• Engage in training and development sessions to enhance your skills and keep abreast of industry changes.
  
  

Required Skills

• Strong decision-making skills related to prior authorization requests.
• Excellent verbal and written communication abilities for effective customer support.
• Keen attention to detail for maintaining accurate documentation.
• Proficiency in managing client exceptions with care and a resourceful mindset.
• Capability in resource management to ensure desk reference materials are current.
• Competence in processing paperwork while adhering to established standards.
• Commitment to ongoing professional development and staying informed about industry advancements.
  
  

Qualifications

• Previous experience in a Pharmacy Benefit Manager (PBM) role with a focus on prior authorizations is essential.
• Previous call center experience or familiarity in handling high-volume calls is required.
• A Bachelor's Degree in Pharmacy is necessary; a Doctor of Pharmacy (Pharm D) is preferred.
• An active, unrestricted Pharmacist license in your state of residence is mandatory.
  
  

Career Growth Opportunities

This position offers a unique chance to advance your career within a dynamic environment, with ample opportunities for skill enhancement and professional development.

Company Culture And Values

Our organization promotes a collaborative and inclusive work environment, where teamwork and communication underpin our commitment to exceptional client service and continuous learning.

Employment Type: Full-Time