All roles

Pharmacist - Prior Authorization - Remote

Remote · USA Full-time New today

Remote Pharmacist openings with a Major Corporation! Don't miss out on these great opportunities to work from home. FULLY REMOTE - Must have Prior Authorization experience! (Looking for it outside of Retail Setting) We have Different openings with different shifts: WE ARE LOOKING FOR FLEXIBILITY! • 1 Position has Shifts available for SUNDAY-THURSDAY or TUESDAY-SATURDAY - will work one weekend day per week basically and the 3 shifts are: 10:30am-7pm CST 11am-7:30pm CST or 11:30am-8pm CST • 1 Position is MONDAY - FRIDAY - 930am - 6pm Local time • Start Dates in September, October, November and more! 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! Jared Petrill /Please apply now! - We will have openings for September, October and November start dates! Apply Job!

Related roles

Blue cross blue shield Remote jobs

Remote · USA Full-time

Virtual Banker - Client Experience Associate

Remote · USA Full-time

Utilization Review Nurse - Remote -id-5250

Remote · USA Full-time

Provider Relations Coordinator (Bilingual - Korean)

Remote · USA Full-time

Senior Audit Manager, Consumer Lending (Hybrid)

Remote · USA Full-time

Software Support Analyst (Investment Finance) (remote)

Remote · USA Full-time

Experienced Loan Partner for Mortgage Broker

Remote · USA Full-time

Sr. Mortgage Recruiter - Remote OK

Remote · USA Full-time

Care Team Associate - Farmington, CT

Remote · USA Full-time

Bank Fraud Issues Management Advisor Senior

Remote · USA Full-time

Apply Now: Remote Scheduling Assistant - Entry Level

Remote · USA Full-time

Remote Data Entry Associate – Teen‑Focused Earn Money Opportunity with arenaflex (Ages 16‑19)

Remote · USA Full-time

Experienced Customer Service Associate - Temporary Role at blithequark

Remote · USA Full-time

Cloud Security Engineer

Remote · USA Full-time

Remote Senior Medicaid Contracting Analyst

Remote · USA Full-time

Business Development Representative

Remote · USA Full-time

Experienced Global Customer Solutions Specialist – Aviation Industry Expertise (Remote) – US

Remote · USA Full-time

Immediately Require Claim Team Manager - Hail Unit - Remote in Dallas, TX

Remote · USA Full-time

Senior Product Manager - Advertising Technology

Remote · USA Full-time

RN Nurse Case Management Lead Analyst- SCO (Pathwell) – Work from Home, Anywhere in Bloomfield, CT in Cigna

Remote · USA Full-time