Work From Home
Must be licensed in the state of North Carolina. (Can reside in any state.)
Shift 11 am to 7:30pm EST
Safety Sensitive
Last Offer: 4/20
Last Day to Clear: 5/8
Must list internet speed test on the resume - www.speedtest.net
Must have active license listed on the resume as well
The basic function of the pharmacist is
Review and complete criteria based on prior authorization as per policy and procedure.
Must ensure the potential new hire understands:
They are required to provide their own high-speed internet.
Minimal home broadband connectivity speed of 25 Mb download and 3 MB upload speed. Speed for home internet can be confirmed by going to www.speedtest.net. Please provide Internet provider and download and upload speeds.
Smartphones are required. The VPN token will need to be downloaded to the users smartphone.
They must have a sufficient/private work area that is used for business during their work hours.
Their current living accommodations are in a stable situation.
That the assignment could be changed to an in-office assignment.
Ensure the employee is aware of the Teleworker Privacy Practices they need to abide by.
Must take steps to ensure that the work area is secure and protects Health property and confidential information from inadvertent or unauthorized access or theft including:
Equipment and information are secure from inadvertent and/or unauthorized access or theft at all times.
Workspace is dedicated to Health business during working hours and is not accessible by others who may be present in the household; telephone conversations cannot be overheard, and documents/computer screens cannot be viewed by others.
When not working, the computer is shut off. For short departures from the work area, the workstation must be locked, or the computer shut down.
This position is for a Clinical Pharmacist working in the Prior Authorization team. This Pharmacist will:
Evaluate and review all prior authorization requests and render coverage determinations based on clinical criteria and plan design. Includes verifying insurance coverage and eligibil ity, 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.
Collaborate with the technicians and prior authorization team members to process referrals, including answering clinical questions and 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. Performs and handles in bound and outbound phone calls with technicians, prior authorization team members, physicians, healthcare providers, and/or patients to facilitate prior authorization requests, answer inquiries, and/or resolve escalations.
Maintain professional and technical knowledge of drug and disease states for the Specialty and Non-Specialty Pharmacy programs administered within the Commercial Prior Authorization and Case Review Unit (CRU) line of business. Perform other related projects and duties as assigned, including attending training sessions and development meetings, and providing on-call and after-hours pharmacist avail ability as needed.
Duties
This individual must have excellent interpersonal skills. Will be responsible for: reviewing patient profile, drug interactions, sensitivities and drug usage database in relation to patient\'s prescription. Determines if prescription requires physician clarification or if it should be forwarded to therapeutic intervention or doctor phone calls for follow-up. Enters prescription in to the computer. Assists in patient services as required, taking incoming prescription medication questions/concerns from patients. Assists in the doctor phone call area and/or therapeutic intervention as assigned and contacts physicians to resolve any questions or concerns. Maintains established procedures concerning quality assurance, security of controlled substances, and disposal of hazardous waste drugs. Works with other members of the pharmacy to ensure accuracy of prescriptions. Dispenses prescription medication and performs final dispensing quality check on all prescriptions for accuracy and dosage.
Experience
Previous pharmacy experience in retail or hospital preferred. Appropriate state license required. Experience in home infusion therapy is preferred. Basic computer skills required. Strong organizational skill, interpersonal skills and detail orientation important for this position. Minimum of one year\'s pharmacy experience in a retail or hospital setting preferred.
Position Summary
This position is for a Clinical Pharmacist working in the Prior Authorization team. This Pharmacist will:
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.
Collaborate with the technicians and prior authorization team members to process referrals, including answering clinical questions and 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. Performs and handles inbound and outbound phone calls with technicians, prior authorization team members, physicians, healthcare providers, and/or patients to facilitate prior authorization requests, answer inquiries, and/or resolve escalations.
Maintain professional and technical knowledge of drug and disease states for the Specialty and Non-Specialty Pharmacy programs administered within the Commercial Prior Authorization and Case Review Unit (CRU) line of business.
Perform other related projects and duties as assigned, including attending training sessions and development meetings, and providing on-call and after-hours pharmacist availability as needed.
We offer a competitive benefit package including vacation, 10 paid holidays per year, health/dental/vision insurance, employee discounted stock purchase program, 401K, tuition reimbursement, and 20-30% employee discount at all stores.
This is a remote role open to candidates within the United States. Candidate can reside in any state, but must hold active Pharmacist licensure in the State of North Carolina.
Education
Bachelors of Science - Pharmacy or Pharm.D.
What days & hours will the person work in this position List training hours, if different.
Mon-Fri 11am-730pm EST