HC - PHARMACIST - INTERMEDIATE
Location: REMOTE Description: REMOTE PHARMACIST - INTERMEDIATE This position is for a Clinical Pharmacist working in the Prior Authorization unit This is a call center based business segment and strict work guidelines are employed. The pharmacists primary role is reviewing Prior Authorization cases and rendering coverage determinations based on clinical criteria and plan design in a fast paced and dynamic environment. Primary Responsibilities:
- Work is computer based and include receiving phone calls from prior authorization pharmacy technicians and/or providers for clinical information
- Consult physicians/providers with questions, interpret clinical guideline criteria, and render/review coverage determination for prior authorization cases
- Consult with pharmacy technicians and/or physicians regarding use of medications and advise of appropriate formulary alternatives when requested.
- Gather complex clinical information, coverage policy and criteria information and work within regulatory guidelines to make coverage determinations
- Organize workload, sets priorities, completes assignments in a timely manner and utilizes resources appropriately while complying with department program standards
- Perform all duties and functions in compliance with state and federal pharmacy laws and regulations
- Conform with and supports department quality assurance and improvement guidelines
- Dedication to build rapport with coworkers, internal customers, and other departments by demonstrating a strong customer service orientation and a continuous positive image of the company.
- Demonstrate ability to maintain productive working relationships with team members, other internal and external customers, and management team.
Skill and Requirements:
- Training is for 4 weeks. Training time is 8:00am-5:00pm. Monday- Friday.
- Shift after training is an 8 hour shift with an hour lunch.
- Candidate must be available as early as 5am and as late as midnight.
- Candidate will work 5 days a week which may or may not include a weekend day(s).
- There is scheduled Overtime and working on Holidays. Dependent on business needs, candidate could work up to 4 hours a day OT.
- Candidate must have their own home internet access/VPN (internet can be hard wired with Ethernet cord)
- Candidate must also have a secure work space/office in their home
- Candidate must have level skill with working with PC (ex. using mouse and keyboard, accessing and navigating through multiple systems and screens)
- Excellent Attendance is a must
- Active state Pharmacist license.
Please email resume to [email protected]. Phone interviews will be set up accordingly By providing your phone number, you consent to: (1) receive automated text messages and calls from the Judge Group, Inc. and its affiliates (collectively "Judge") to such phone number regarding job opportunities, your job application, and for other related purposes. Message & data rates apply and message frequency may vary. Consistent with Judge's Privacy Policy, information obtained from your consent will not be shared with third parties for marketing/promotional purposes. Reply STOP to opt out of receiving telephone calls and text messages from Judge and HELP for help. Contact: [email protected] This job and many more are available through The Judge Group. Find us on the web at www.judge.com Remote About the Company: Judge Group The Judge Group Inc., is a leading professional services firm specializing in talent, technology, and learning solutions. We consult, staff, train, and solve. Through our work we make people and organizations better. Our services are successfully delivered through a network of more than 30 offices across the United States, Canada, and India. The Judge Group is proud to partner with the best and brightest companies in business today, including over 60 of the Fortune 100. We serve organizations in financial services, healthcare, life sciences, insurance, government (including aerospace and defense), manufacturing, and technology and telecommunications. If you would like to learn more about The Judge Group visit www.judge.com or call toll free (800) 360-4474. Company Size: 5,000 to 9,999 employees Industry: Computer/IT Services Founded: 1970 Website: https://www.judge.com Apply tot his job Apply To this Job