Pharmacist - Remote - Prior Authorization

Pharmacist needed for Remote / Work From Home Position! Multiple openings with a July and August Start Dates coming next! Pay Rate: 53.00 per hour depending on what role we get you in for! 3 Different Departments hiring during this time of year - Here is the options:

• 1 Opening: 8am to 8pm EST/CST - 8hours per day M-F or 7am-330p EST/CST rotating weekends
• 1 Opening: Monday - Friday 930am - 6pm
• 1 Opening: (Sun-Thurs or Tues-Sat): 10:30am-7pm CST or 11am-7:30pm CST or 11:30am-8pm CST

Job Description:

• Evaluate and review all prior authorization requests and render coverage determinations based on clinical criteria and plan design. Includes verifying insurance coverage and eligibility, interpreting clinical guideline criteria, consulting physicians and other healthcare providers, and appropriately utilizing clinical knowledge and resources while complying with department protocols.
• One of the crucial responsibilities is to guarantee that the decisions regarding cases are conveyed promptly and efficiently to all the healthcare providers, health plans/employers, patients, and other healthcare professionals following agreed-upon approval & denial management processes.
• As an RPh Advisor you will be directly supporting Medicare Part D members and providers with requests related to their pharmacy benefits.
• You will be responsible for ensuring cases are accurately set up for our members, review clinical information for decisioning the request, performing outreach to providers for more information when needed, and ensuring accurate decisions that comply with compendia and Medicare guidance and timelines.
• This is a great opportunity to initiate a career with a leading healthcare company by reviewing information and completing timely and accurate documentation of all Medicare Part D requests, in compliance with Medicare guidelines, while promoting a best-in-class service experience.

Job Requirements:

• Must be licensed Pharmacist in the State you Reside in
• Looking for Pharmacist with Prior Authorization Experience - PBM! (Not retail experience)
• Must have home office/ability to work from home with no distractions and plug in ethernet

Benefits/401k Opportunity!

• Benefits are available to full-time employees after 90 days of employment
• A 401(k) with a company match is available for full-time employees with 1 year of service on our eligibility dates

Please apply now to these Pharmacist Openings! - Jared Petrill