Logo for ICONMA

Pharmacist - Prior Authorizations

ICONMA

Role overview

Qualifications

  • Bachelor’s degree in pharmacy or PharmD
  • Minimum 2 years’ recent experience reviewing and processing prior authorizations
  • Excellent organizational skills
  • Strong Microsoft Office skills

Responsibilities

  • Evaluate and review all prior authorization requests and render coverage determinations based on clinical criteria
  • Collaborate with technicians and prior authorization team members to process referrals
  • Maintain professional and technical knowledge of drug and disease states
  • Perform in bound and outbound phone calls to facilitate prior authorization requests

Key facts

Hard skills

Prior Authorization Clinical Assessments Drug Education Clinical Practices

Other skills

  • Organizational Skills
  • Microsoft Office
  • Collaboration
  • Detail Oriented
  • Adaptability
  • Time Management

About the company

ICONMA logo

ICONMA

Management Consulting

We provide Professional Staffing Services & Project-Based Solutions for a broad range of Fortune 500 organizations. ICONMA is a certified Woman-Owned staffing company and was founded in 2000. ICONMA’s corporate headquarters is in Troy, Michigan, and has 15+ locations worldwide. What makes ICONMA stand out in a fiercely competitive industry? *We provide integrated, full lifecycle services across a broad range of business and technical platforms. *No single company can duplicate our full range of staffing and permanent recruiting services nationwide. *Proven track record of attracting and retaining exceedingly skilled professional workers in a highly competitive market. SERVICES OFFERED Staff Augmentation (Contract, Contract to Hire, Direct Hire, Single Source) Data Analysis Project-Based Services & Solutions Hire Train Deploy Service Model Offshore Staff Augmentation Payroll Services AREAS OF EXPERTISE - Information Technology - Engineering - Business Professional - Accounting/Finance - Admin/Clerical/Call Center - Healthcare/Clinical/Scientific - Marketing/Creative mail linkedin@iconma.com Phone (888) 451-2519 Website http://www.iconma.com

Company details

Company typeLarge
IndustryManagement Consulting
Company size1001 - 5000

Links

Website LinkedIn See all jobs

Your match analysis

See how your profile stacks up against this role.

We compared the job requirements to your profile to show where you're strong and where you fall short.

Job description

Our Client, a Retail Pharmacy company, is looking multiple Pharmacists with prior authorization experience to work remotely.

Responsibilities:
  • Evaluate and review all prior authorization requests and render coverage determinations based on clinical criteria and plan design.
  • Includes verifying insurance coverage and eligibility, interpreting clinical guideline criteria, consulting physicians and other healthcare providers, and appropriately utilizing clinical knowledge and resources while complying with department protocols.
  • One of the crucial responsibilities is to guarantee that the decisions regarding cases are conveyed promptly and efficiently to all the healthcare providers, health plans/employers, patients, and other healthcare professionals following agreed-upon approval & denial management processes.
  • Collaborate with the technicians and prior authorization team members to process referrals, including answering clinical questions and collecting appropriate clinical/medical data needed to perform clinical assessments and reviews as per the health plan/employer- agreed criteria within the designated service level agreements.
  • Performs and handles in bound and outbound phone calls with technicians, prior authorization team members, physicians, healthcare providers, and/or patients to facilitate prior authorization requests, answer inquiries, and/or resolve escalations.
  • Maintain professional and technical knowledge of drug and disease states for the Specialty and Non-Specialty Pharmacy programs administered within the Commercial Prior Authorization and Case Review Unit (CRU) line of business.
  • Perform other related projects and duties as assigned, including attending training sessions and development meetings, and providing on-call and after-hours pharmacist avail ability as needed.
  • Demonstrated experience using clinical resources, e g., Micromedex, Lexicomp, Clinical Pharmacology
  • Ability to prioritize, quickly assess, manage multiple tasks and adapt to constantly changing situations.
 
Requirements:
  • Excellent organizational skills. Strong detail orientation.
  • Strong Microsoft Office skills.
  • Ability to receive phone calls from prior authorization pharmacy technicians and/or providers for clinical information.
  • Minimum 2 years’ recent experience reviewing and processing prior authorizations against health plan criteria for a determination in a specialty/skilled clinical setting i.e., specialty medical office or Pharmacy Benefits Manager (PBM)
  • Bachelor’s degree in pharmacy or PharmD
 
Why Should You Apply?  
ICONMA is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to any status protected by applicable law.
 

Apply once. Then go straight to the hiring manager.

After you apply, unlock the direct contact details of the people who actually make the call. A quick follow-up makes you 5x more likely to land an interview.

MR

Marcus Rivera

Chief Revenue Officer

m.rivera@company.com
linkedin.com/in/marcusrivera
Unlocked after you apply
·

Pharmacist Related jobs

California (USA)Pharmacist

Other jobs at ICONMA

Premium

Reach out to the hiring manager directly.

Gain access to the contact details of the hiring managers who actually decide, and reach out to network with them directly. That, plus more when you upgrade:

  • Full match report with fit score and gaps
  • Career diagnostics on how recruiters read you
  • Curated company matches and warm intros
  • 48h early access to new roles

Cancel anytime.