Pharmacist - RPh Operations Advisor

Our client, a Retail Pharmacy company, is looking for a Pharmacist - RPh Operations Advisor for their Remote location.

Responsibilities:

• This individual must have excellent interpersonal skills. Will be responsible for:
• Collaborates with the Technicians and Nurses 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 client 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%)
• 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 client Caremark supported systems and take inbound calls from physician or members regarding their pending, approved, or denied prior authorizations.

Requirements:

• Technical & Computer Proficiency
• Comfortable navigating multiple systems simultaneously
• Strong Windows proficiency
• Ability to learn new technologies quickly
• Comfortable utilizing AI-assisted productivity tools
• Smartphone utilization for VPN access
• Self-Management and Organizational Skills
• Able to work independently
• Effective prioritization skills
• Strong time management
• High attention to detail
• Successful performance in production-based environments
• Clinical Prior Authorization Review Exp
• Verifyable High School Diploma or GED Required
• 2+ years of clinical experience with specialty medications or clinical review of prior authorization requests
• Experience using MS Office and other Windows based computer applications, strong organizational skills, interpersonal skills, and detail orientation are important for this position.
• Active pharmacist license in state of residence in good standing
• Bachelor's degree in pharmacy or Pharm D. required with at least two years experience as a pharmacist.
• Must have an active license in good standing.

Why Should You Apply?

• Health Benefits
• Referral Program
• Excellent growth and advancement opportunities