Remote Prior Authorization Pharmacist - PBM | WFH

Job Overview

We invite you to join our dynamic team as a Remote PBM Prior Authorization Pharmacist. In this pivotal role, you will ensure that patients have access to the essential medications they require. Collaborating across departments, you will address clinical inquiries, compile critical clinical and medical information for assessments, and conduct reviews in alignment with established health plan and employer guidelines.

Key Responsibilities

• Collaborate with diverse teams to provide comprehensive answers to clinical inquiries while gathering vital clinical and medical data for thorough assessments, ensuring compliance with service level agreements.
• Facilitate efficient communication of case determinations to physicians, health plans, employers, patients, and fellow healthcare professionals, adhering to set approval and denial management processes.
• Conduct reviews of ongoing cases and deliver clinical decisions regarding prior authorizations, tier exceptions, and non-formulary requests to bolster patient care.
• Engage in additional related projects and responsibilities as required, including on-call and after-hours support as necessary.
  
  

Required Skills

• Proficiency in Access, PowerPoint, and Visio; familiarity with Excel and Word is crucial.
• Strong communication and organizational skills, enabling effective collaboration across departments.
  
  

Qualifications

• Must hold a valid Registered Pharmacist license in your state of residence.
• A minimum of 1 year of pharmacy experience is mandated; 2-5 years is preferred.
• Current pharmacist license in good standing is essential.
  
  

Career Growth Opportunities

This role offers the potential for significant professional development within a collaborative environment, allowing you to enhance your skills and advance your career in the pharmacy sector.

Compensation And Benefits

We recognize the contributions of our employees and provide a comprehensive benefits package for full-time team members following 90 days of employment, which includes:

• Health, optical, dental, life, and short-term disability insurance
• A 401(k) plan with company match available for full-time employees after one year of service
  
  

If you are a dedicated pharmacist eager to make a meaningful impact on patient care while enjoying the flexibility of remote work, we encourage you to submit your application today.

Employment Type: Full-Time