• Philadelphia, PA
  • Remote
  • Quick Apply
15 days ago

Job Description

 
Remote - Candidates must be able to work EST schedule
Duties:

As a licensed healthcare professional employed in the Prior Authorization Department the primary responsibility of Pharmacist (R) is to make determinations on prior authorization requests for coverage of pharmaceutical products. Determinations include medical necessity and benefit decisions. Decisions are made in accordance with established pharmacy guidelines, prior authorization criteria, industry regulations and sound clinical judgment.

Prior Authorization Pharmacist (R) works independently with respect to reviews and decision making, with the support of Pharmacist II (R)s and supervisors. Pharmacist (R) works as a member of a team of peers committed to meeting or exceeding quality standards and customer performance guarantees. This position includes a rotating weekend schedule if business needs dictate.

Additional responsibilities include:
Provide clinical support to the PerformRx Customer Care Center

Engage providers in discussions to support determinations

Support Fraud and Abuse program oversight

Keep abreast of industry trends and regulatory changes

Keep abreast of operational directives and customer reference materials

Skills:

No experience required, Prior Authorization or Coverage Determination experience preferred

Proficient PC skills in a Windows based environment

Education:

Bachelor's Degree, PharmD preferred

Current Pharmacist license

Skills:

Required

  • WINDOWS ENVIRONMENT PROFICIENCY
  • PRIOR AUTHORIZATION
  • COVERAGE DETERMINATION
  • PC SKILLS

Additional

    Languages: English( Speak, Read, Write )
    Minimum Degree Required: Bachelor's Degree

    All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.

    Numbers & Facts

    LocationPhiladelphia, PA (
    Remote
    )
    IndustryComputer/IT Services
    Company Size100 to 499 employees
    Year Founded1997
    Websitehttps://www.tscti.com/careers-0

    About Company

    22nd Century Technologies, Inc., is one of the fastest growing IT Service Integrator and Workforce Solution companies in the United States. Founded in 1997, 22nd Century Technologies is a Certified National Minority Business Enterprise with 6,000+ people including 600+ Cyber SMEs nationwide supporting our customers in all 50 states, Canada, and Mexico. With HQs in Somerset, NJ and Mclean, VA, 22nd Century has 14 offices throughout the United States. As part of our unrelenting focus on quality and compliance, 22nd Century Technologies’ delivery is based on Certified Matured Processes including CMMI L3 Dev & SVC, ISO 20000, ISO 27001, and ISO 9001 quality processes. With a strong focus on the public sector, 22nd Century currently holds government contracts with 14 out of 15 Federal Executive agencies including DoD, 37 other Federal agencies, 50 States, 115+ Local agencies, and 37 School Districts. In the last three years, we have expanded our services to Fortune 500 and other commercial clients and currently support 80+ commercial clients.

    Recognized among “Best Company to Work For” by Forbes, 22nd Century Technologies, Inc., consistently exceeds our clients’ expectations by focusing on their absolute satisfaction with jobs while keeping our employees motivated.

    All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.

    Skills

    • Biotech and Pharmaceuticalunmatched
    • Clinical Supportunmatched
    • Computer Skillsunmatched
    • Customer Support/Serviceunmatched
    • English Languageunmatched
    • Healthcareunmatched
    • Industry/Trade Analysisunmatched
    • Microsoft Windows Operating Systemunmatched
    • Patient Care Authorizationsunmatched
    • Pharmacyunmatched
    • Quality Metricsunmatched
    • Referenceable Customersunmatched
    • Regulationsunmatched
    • Team Playerunmatched

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