PBM Prior Authorization REMOTE Pharmacist

Job Description

Job Description

A-Line Staffing is now hiring REMOTE PBM Prior Authorization Pharmacist! The REMOTE PBM Prior Authorization Pharmacist would be working for a Fortune 500 company and has career growth potential. This would be full time / 40+ hours per week.

REMOTE PBM Prior Authorization Pharmacist Compensation

• Benefits are available to full-time employees after 90 days of employment and include health, optical, dental, life, and short-term disability insurance
• A 401(k) with a company match is available for full-time employees with 1 year of service on our eligibility dates

REMOTE PBM Prior Authorization Pharmacist Highlights

• This position is a contract assignment with potential to hire on permanently based upon attendance, performance, and business needs
• The required availability for this position is (Shifts assigned after training)
• • 1. Tuesday-Saturday 8am-4:30pm CST
  • 2. Sunday-Thursday 8am-4:30pm CST
  • 3. Monday-Friday 9:30am-6pm CST

REMOTE PBM Prior Authorization Pharmacist Responsibilities

• The clinical pharmacist is an operation-based role that conducts clinical reviews of medical data collected to perform prior authorization for specialty medications.
• The clinical pharmacist will apply clinical knowledge to plan approved criteria for prospective and concurrent reviews of cases.
• This role will work from supported systems and take inbound calls from physician or members regarding their pending approved or denied prior authorizations.
• Collaborates with the CRU Technician to process referrals including answering clinical questions collecting appropriate clinical/ medical data needed to perform clinical assessments and reviews as per the healthplan/employer agreed criteria within the designated service level agreements.
• Coordinates timely communication of case decision to physician health-plan/employer patient and other healthcare professionals following agreed upon approval denial management processes. 
• Handles inbound phone calls and escalations from physicians or patients regarding Prior Authorization.
• Maintain professional and technical knowledge of drug and disease-states for the Specialty Pharmacy programs administered within the Case Review Unit

REMOTE PBM Prior Authorization Pharmacist Requirements

• 1 year of recent experience with PBM prior authorization
• Active and in good standing Pharmacist license in the state in which you sit
• Attendance is mandatory for the first 90 days

If you think this REMOTE PBM Prior Authorization Pharmacist position is a good fit for you, please reach out to me - feel free to call, e-mail, or apply to this posting!