Job Overview
We are seeking a dedicated and experienced Remote Prior Authorization Pharmacist to join our dynamic healthcare team. In this pivotal role, you will collaborate with various clinical teams to support medication requests and ensure compliance with health plan criteria. Your expertise will be instrumental in enhancing patient care through effective clinical assessments.
Key Responsibilities
- Clinical Collaboration (20%): Engage with internal teams to resolve clinical inquiries and obtain required medical information for thorough assessments.
- Communication and Case Coordination (20%): Maintain timely and precise communication regarding case determinations with healthcare professionals, including physicians and health plan representatives, while adhering to established approval and denial protocols.
- Clinical Decision-Making (50%): Evaluate and make informed clinical decisions on prior authorizations, tier exceptions, and non-formulary requests, striving for optimal patient outcomes.
- Additional Responsibilities (10%): Contribute to various projects as needed and provide on-call and after-hours support when required.
Required Skills
- Proficiency in Microsoft Office Suite, particularly Excel and Word; familiarity with Access, PowerPoint, and Visio is preferred.
- Strong attention to detail and capacity to make sound clinical decisions in a fast-paced environment.
- Excellent interpersonal and communication skills to facilitate coordination with healthcare professionals.
Qualifications
- Must hold a valid Registered Pharmacist license in your state of residence.
- A minimum of 1 year in a related role is required; 2-5 years of experience is preferred.
Career Growth Opportunities
This role offers a promising pathway for professional development, enabling you to enhance your skills and take on additional responsibilities within the healthcare field, fostering career advancement.
Company Culture And Values
We pride ourselves on our values of collaboration, professionalism, and commitment to delivering high-quality patient care. Our organizational culture promotes teamwork and open communication, making it an ideal environment for professionals dedicated to making a difference in healthcare.
Compensation And Benefits
- Comprehensive Benefits Package: Health, dental, vision, life insurance, and short-term disability benefits are available to full-time employees after 90 days.
- Retirement Plan: 401(k) with company match after 1 year of service, aligning with our eligibility criteria.
If you are passionate about driving positive change in healthcare and possess the qualifications we seek, we invite you to apply and join our esteemed team.
Employment Type: Full-Time
