Clinical Pharmacist

Remote Compliance Reviewer100% Remote in the 28 states - North Carolina, Alabama, Arizona, Arkansas, Colorado, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Michigan, Mississippi, Missouri, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Wisconsin, and Wyoming will be allowed to maintain their current residence and work remotely. Screening question: Have you had any experience with compliance work where you had timelines to meet? If so, please explain.Description:Review prior authorization requests and make determinations for drug products according to member benefits and coverage criteriaReport to utilization review statistics to corporate compliance committeesReview data and summarize daily utilization review numbersResponsible for tracking compliance of review casesProvide clinical guidance and support to the assigned pharmacy techniciansKnowledge of drug coding (NDC, GCN, GPI and USC) and NCPDP claims adjudication systemsReview guideline criteria for prior authorization and non-formulary drugs in support of Pharmacy and Therapeutics Committee function and pharmacy benefit designEnsure and evaluate quality controls and implement opportunities for performance improvement in pharmacy practicesResearch drug information to maintain drug knowledge and disease state understanding for application to prior authorization reviewsHiring Requirements:Bachelor's degree or advanced degree3+ years of experience in related fieldCurrent states pharmacy licenseEEO: Mindlance is an Equal Opportunity Employer and does not discriminate in employment on the basis of – Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans.