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Pharmacist - Prior Authorization - Remote
A-Line Staffing Solutions • Remote • Posted 1 day ago via ZipRecruiter
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Remote • Full-time • $53.00/hr • Mid Level
Job Highlights
Using AI ⚡ to summarize the original job post
The Pharmacist - Prior Authorization position at A-Line Staffing Solutions involves performing clinical review of prior authorization requests, coordinating the distribution of clinical drug information, and educating providers and staff on the appropriate use of pharmaceutical treatment regimens. This role supports the clinical pharmacy team, participates in quality initiatives, and handles other projects as needed. Training for this role will be conducted remotely, with sessions scheduled from Monday to Friday, 8:00am-4:30pm CT.
Responsibilities
- Perform clinical review of prior authorization requests.
- Utilize clinical experience and skills to apply appropriate clinical criteria/guideline, policy, procedure, and clinical judgment to render appropriate coverage determination.
- Monitor prescribing habits of participating physicians.
- Make recommendations to physicians to improve medication regimens as appropriate.
- Develop programs to provide optimal pharmacy care to patients.
- Participate in dispute resolution of drug utilization review.
- Measure and document improvements in patient care.
- Improve claim adjudication for proper provider reimbursement.
- Act as a subject matter expert for clinical pharmacy issues.
- Consult and lend expertise in the coordination and administration of the utilization/benefit management function.
- Educate providers and staff on the appropriate use of pharmaceutical treatment regimens.
- May develop and maintain training documents for staff development.
- Perform other duties as required.
About A-Line Staffing Solutions
A-Line Staffing Solutions is a prominent staffing agency in the pharmaceutical, medical, and IT industries, connecting top talent with great career opportunities nationwide. They specialize in providing flexible staffing solutions for healthcare, IT, and administrative professionals, emphasizing strong client relationships and effective communication. Job seekers can benefit from their extensive network and a wide range of positions in various fields.
Full Job Description
Job Description
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 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
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