Pharmacist

Position Title: Pharmacist


Location: Remote EST


Duration: 3 Months


Schedule: Mon - Fri 8:00 AM - 5:00 PM.


PR: $60-65/hour on W2

Job Description:

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

Requirement:


Bachelor's Degree, PharmD preferred


Current Pharmacist license


No experience required, Prior Authorization or Coverage Determination experience preferred


Proficient PC skills in a Windows based environment