Pharmacist - RPh Operations Advisor (Specialty Medical Prior Authorization)

Job Responsibilities:

• 2+ years of clinical experience with *specialty medications* or *clinical review of prior authorization requests*.
• Experience using MS Office and other Windows based computer applications, strong organizational skills, interpersonal skills, and detail orientation are important for this position.
• Required certification: Active pharmacist license in state of residence in good standing

Skills:

• Collaborating with 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%)
• Coordinating timely communication of case decision to physician, health-plan/employer, patient and other healthcare professionals following agreed upon approval & denial management processes. (15%)
• Handling inbound phone calls and escalations from physicians or patients regarding Prior Authorization (50%)
• Establishing and maintaining communication among health plans and employer group staff. (5%)
• Maintaining professional and technical knowledge of drug and disease-states for the Specialty Medical programs administered within the Novologix platform. (5%)
• Performing other related projects and duties assigned. On call and after-hours pharmacist availability may be required. (5%)

Education/Experience:

• 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.