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Pharmacist #26-25796

US Tech Solutions

Role overview

Qualifications

  • Bachelor’s Degree, PharmD preferred
  • Current Pharmacist license
  • 5+ years of experience
  • Windows environment proficiency

Responsibilities

  • Make determinations on prior authorization requests for coverage of pharmaceutical products
  • Ensure decisions are made in accordance with established pharmacy guidelines and regulations
  • Provide clinical support to the client Customer Care Center
  • Engage providers in discussions to support determinations

Key facts

Hard skills

Other skills

  • Communication
  • Teamwork

About the company

US Tech Solutions logo

US Tech Solutions

Staffing & Recruiting

USTECH SOLUTIONS is the largest privately owned diversity workforce partner with a global footprint. For 20+ years, we have partnered with leading MSPs and some of the world’s largest enterprises to deliver a flexible workforce. We serve Fortune 500 giants and growing businesses alike, reinventing the role of humans in a digital workforce. ‘Reinventing Human’ is about connecting you with top talent and seamlessly integrating new hires into your programs through our next gen AI powered Talent platforms. As the largest private diversity supplier in the US, we champion inclusion and unlock hidden potential. We work with leading MSPs and are a trusted strategic partner to the world’s top brands. At USTECH SOLUTIONS, we're inverting the talent hiring pyramid by offering a range of solutions from curated talent pools, workforce management services, and IT services resourcing to IC compliance. Our legacy and close affinity to the computing industry has equipped us with the expertise and vision to provision AI platform solutions that help organizations to innovate faster. Considering Statement of Work? Meet US Tech Digital (ustechdigital.com). We're helping businesses achieve digital leadership through our tailored SOW solutions, utilizing market-leading technology products and our proprietary in-house developed platform solutions. Explore our full range of services and solutions by visiting our website: ustechsolutions.com

Company details

Company typeLarge
IndustryStaffing & Recruiting
Company size1001 - 5000

Links

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Job description

Duration: 03 months with possible extension
 
Summary:
  • The Prior Authorization Pharmacist reviews pharmaceutical coverage requests and determines medical necessity and benefit eligibility based on clinical guidelines and regulatory requirements. Responsibilities include supporting customer care, communicating with healthcare providers, and ensuring quality and compliance in coverage decisions. Requires a current pharmacist license, a bachelor's degree in pharmacy, and proficiency in Windows-based systems. Prior authorization experience is preferred but not required.
 
Responsibilities
  • As a licensed healthcare professional employed in the Prior Authorization Department the primary responsibility of Pharmacist (R) is to make determinations on prior authorization requests for coverage of pharmaceutical products.
  • Determinations include medical necessity and benefit decisions. Decisions are made in accordance with established pharmacy guidelines, prior authorization criteria, industry regulations and sound clinical judgment. 
  • Prior Authorization Pharmacist (R) works independently with respect to reviews and decision making, with the support of Pharmacist II (R)s and supervisors.
  • Pharmacist (R) works as a member of a team of peers committed to meeting or exceeding quality standards and customer performance guarantees. This position includes a rotating weekend schedule if business needs dictate.
  • Additional responsibilities include:
  • Provide clinical support to the client Customer Care Center
  • Engage providers in discussions to support determinations
  • Support Fraud and Abuse program oversight
  • Keep abreast of industry trends and regulatory changes
  • Keep abreast of operational directives and customer reference materials
 
Experience:
  • 5+ years of experience.
 
Education:
  • Bachelor’s Degree, PharmD preferred
  • Current Pharmacist license
 
Required Skills:
  • Windows environment proficiency
  • Prior authorization
  • Coverage determination
  • Pc skills
 
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.
 
AI Statement: By applying, you acknowledge that AI-assisted tools may be used during hiring. 
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