Remote pharmacist - prior authorization - united states, woonsocket

adecco is currently assisting a national pharmaceutical client, recruiting for a remote pharmacist. the clinical pharmacist is an operation based role that conducts clinical reviews of medical data collected to perform prior authorization for specialty medications. the clinical pharmacist will apply clinical knowledge to plan approved criteria for prospective and concurrent reviews of cases. this role will work from cvs caremark supported systems and take inbound calls from physician or members regarding their pending, approved, or denied prior authorizations.  apply now!

responsibilities

collaborates with the technicians to process authorization requests, including answering clinical questions, collecting appropriate clinical/ medical data needed to perform clinical assessments, and reviews as per the health plan/employer agreed criteria within the designated service level agreements. (20%)

coordinates timely communication of case decision to physician, health-plan/employer, patient and other healthcare professionals following agreed upon approval & denial management processes. (15%)

handles inbound phone calls and escalations from physicians or patients regarding prior authorization (50%)

establishes and maintains communication among cvs caremark, health plan and employer group staff. (5%)

maintain professional and technical knowledge of drug and disease-states for the specialty medical programs administered within the novologix. (5%)

performs other related projects and duties as assigned including on call and after hours pharmacist availability could be required. (5%)

candidates must meet the following requirements to be considered: 

licensed registered pharmacist.

must be computer literate – knowledge of excel and word.

minimum 3-5 years experience preferred, but not required.

excellent customer service skills (written and verbal) a must.
 

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equal opportunity employer/veterans/disabled



the company will consider qualified applicants with arrest and conviction records

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