HC - PHARMACIST - INTERMEDIATE

• This position is for a Clinical Pharmacist.
•  This is a call center based business segment and strict work guidelines are employed. 
•  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  
• Dedication to build rapport with coworkers, internal customers, and other departments by demonstrating a strong customer service orientation and a continuous positive image.
•  Demonstrate ability to maintain productive working relationships with team members, other internal and external customers, and management team. *
  

• Training is for 4 weeks. Training time is 8:00am-5:00pm. Monday- Friday. 
•  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. 
• 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 
• Excellent Attendance is a must active state Pharmacist license.
  

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