State Licensed Pharmacist

Working remotely in the CST time zone, the contract State Licensed Pharmacist will review Prior Authorization cases and render coverage determinations based on clinical criteria while collaborating with pharmacy technicians and providers in a fast-paced call center environment. Key responsibilities Decisioning and processing member prescriptions or prior authorizations through various computer systems, ensuring data accuracy Consulting with physicians/providers regarding clinical information and interpreting clinical guideline criteria for coverage determinations Gathering complex clinical information and working within regulatory guidelines to make informed coverage decisions Required qualifications Bachelor's or Doctorate of Pharmacy degree Active State Pharmacist License in the state of residence Ability to work in a computer-based environment and navigate multiple systems Availability for an 8-hour shift, including potential weekends and overtime as needed Secure workspace and reliable home internet access