Pharmacist - Prior Authorization - Remote
Dallas / Fort Worh, TX US
Remote Pharmacist openings with a Major Corporation! Don't miss out on these great opportunities to work from home.
Mon-Fri 9:30am-6:00pm - Training will be Mon-Fri 8:00am-4:30pm CT
New Position with different hours as well: Tues-Sat or Sun-Thurs 9amCST starts or later! Are you flexible??? November and January Start Dates still coming!
Title - Pharmacist- Prior Authorization
Pay - 53.00 per hour pending experience
Description - The position will perform clinical review of prior authorization requests, coordinate the distribution of clinical drug information, and educate providers and staff regarding the appropriate use of pharmaceutical treatment regimens. In addition, the position will support the clinical pharmacy team, supporting quality initiatives as well as other projects as needed by the line of business.
Performs clinical review of prior authorization requests. Utilizes clinical experience and skills in a collaborative process to apply the appropriate clinical criteria/guideline, policy, procedure and clinical judgment to render appropriate coverage determination. Monitors prescribing habits of participating physicians. Makes recommendations to physicians to improve medication regimens as appropriate.
- Improves quality of service to members by developing programs to provide optimal pharmacy care to patients, participating in dispute resolution of drug utilization review, measuring and documenting improvements in patient care, and/or improving claim adjudication for proper provider reimbursement.
- Acts as "subject matter expert" for clinical pharmacy issues (i.e., appeal, fraud, cognitive services, drug reviews, and education). Consults and lends expertise to other internal and external constituents in the coordination and administration of the utilization/benefit management function. Educates providers and staff regarding the appropriate use of pharmaceutical treatment regimens. May develop and maintain training documents for staff development.
- Performs other duties as required
- This is a WFH position for candidates with a strong clinical/technical knowledge base and independent problem-solving skills. Pharmacist can have an RPh or Pharm.D degree
- Must have active license in state you reside in!