Pharmacist - RPh Operations Advisor - Specialty Medical Prior Authorization

Job Title: Pharmacist
Job Duration: 12+ Months (Possibilities of extension)
Job Location: Flower Mound, TX 75028
Training shift: 7am to 10pm CST - 8 hours/day
Training: M-F 8-4:30PM CST for 6 weeks

Position Summary:
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 Client supported systems and take inbound calls from physician or members regarding their pending, approved, or denied prior authorizations.

Duties:
This individual must have excellent interpersonal skills. Will be responsible for:
1. 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%)
2. Coordinates timely communication of case decision to physician, health-plan/employer, patient and other healthcare professionals following agreed upon approval & denial management processes. (15%)
3. Handles inbound phone calls and escalations from physicians or patients regarding Prior Authorization (50%)
4. Establishes and maintains communication among Client Client, health plan and employer group staff. (5%)
5. Maintain professional and technical knowledge of drug and disease-states for the Specialty Medical programs administered within the Novologix. (5%)
6. Performs other related projects and duties as assigned including on call and after hours pharmacist availability could be required. (5%)

Experience:
2+ years of clinical experience with *specialty medications* or *clinical review of prior authorization requests*.
1. Technical & Computer Proficiency

2. Self-Management and Organizational Skills

3. Clinical Prior Authorization Review Exp

Education:
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.