Remote Prior Authorization Pharmacist - PBM | Work From Home

Job Overview

We are seeking a dedicated and knowledgeable PBM Prior Authorization Pharmacist to join our team in a remote capacity. This crucial role involves conducting comprehensive clinical reviews of medical data, ensuring that specialty medications are authorized in a timely manner. As a member of our organization, you will contribute to enhancing patient care while enjoying the benefits of working from home.

Key Responsibilities

• Perform clinical reviews to facilitate prior authorization for specialty medications.
• Leverage your clinical expertise to create approved criteria for case reviews.
• Handle inbound calls from physicians and patients regarding prior authorizations.
• Collaborate effectively with the Case Review Unit (CRU) Technician to streamline referrals and address clinical inquiries.
• Communicate case decisions promptly to all relevant stakeholders, adhering to established approval processes.
• Stay current with the latest information on drugs and disease states pertinent to the Specialty Pharmacy programs managed within the CRU.
  
  

Required Skills

• Strong clinical knowledge of medications and disease states relevant to specialty pharmacy.
• Excellent communication abilities to engage with healthcare professionals and patients.
• Proven collaboration skills to work effectively with team members.
• Proficiency in conducting clinical assessments and reviews.
• Familiarity with prior authorization processes in a pharmacy benefit management context.
  
  

Qualifications

• A minimum of one year of recent experience in PBM prior authorization.
• An active and valid Pharmacist license in your state of residence.
• Mandatory attendance is required for the initial 90 days.
  
  

Career Growth Opportunities

This position offers a contract assignment with the possibility of transitioning to a permanent role based on attendance, performance, and business needs. We prioritize the professional development of our employees and encourage ongoing learning within our organization.

Compensation And Benefits

We provide a robust benefits package for full-time employees after 90 days, including:

• Comprehensive health, optical, dental, life, and short-term disability insurance.
• A 401(k) plan with company matching, available after one year of service.
  
  

If you are a committed professional seeking to make a meaningful impact in patient care and believe this remote PBM Prior Authorization Pharmacist role aligns with your career aspirations, we welcome you to apply or reach out directly for more information. We look forward to connecting with you!

Employment Type: Full-Time