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:
• Review Prior Authorization requests from medical professionals to ensure alignment with Preferred
Drug List (PDL) criteria and current clinical guidelines.
• Support Peer to Peer discussions with medical providers to discuss Prior Authorization reviews
• Collaborates on the refinement of consultation scripting; solicits and utilizes input from those
contacted toward scripting improvements.
• 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.
• 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.
• 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:
• PharmD or B.S. in Pharmacy with relevant Specialty background.
• Registered Pharmacist with unrestricted respective State Licensure (Connecticut Pharmacist License
Preferred but not required).
• 4 years’ experience in clinical pharmacy.
• Strong verbal and written communications skills.
• Highly skilled with Microsoft Office products and ability to quickly learn proprietary systems.
Basic Qualifications:
• Experience in the coordination of and collaboration of work teams preferred.
• Ability to perform clinical reviews using relevant compendia and clinical trial data.
• Managed care and/or prior authorization experience a plus.
• Strong research and implementation skills in practical settings.
• Analytical skills which can translate into practical and pragmatic recommendations.
• 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
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