Pharmacist

PharmacistChattanooga, Tennessee, United States$ 66.00 - 67.00 (US Dollar)Pharmacist needs 8 years of strong experience in the technical design, development, implementation and support of enterprise solutions.Pharmacist requires:COVID-19 vaccine mandate.Doctor of Pharmacy (PharmD) Degree3 years - Clinical experience required, and preference for coverage review experience.Competency in compendia navigation and research Proficient in Microsoft Office (Outlook, Word, Excel and Powerpoint)Must be a team player, be organized and have the ability to handle multiple projects Excellent oral and communication skillsStrong interpersonal and organizational skillsSolid understanding of regulatory guidelines (FDA, NCQA, EQRO, CMS) requiredKnowledge of medical and pharmacy products LicenseLicensed in Tennessee to practice Pharmacy, or eligible for licensure in the state of TennesseePharmacist duties:Performs prospective and retrospective coverage reviews and appeals per State and Federal regulationsResponds to prescriber, pharmacy provider, member appeals, grievances and complaints related to the provision of pharmaceutical services within established time periodsBuilds and maintains decision trees in the prior authorization systemMaintains denial rationale associated with clinical criteria and ensures that decision letters meet regulatory compliance