New Jersey Licensed Pharmacy Specialist

VirtualVocations

Supporting pharmacy services in a full-time remote capacity, the New Jersey Licensed Pharmacy Specialist will manage prior authorization requests, engage with healthcare providers, and ensure compliance with regulatory standards. Key responsibilities Handle telephonic interactions regarding pharmacy eligibility, coverage determinations, and claim issues Conduct clinical interventions to facilitate formulary compliance and optimize dispensing practices Process complaints, appeals, and grievances while identifying potential fraud, waste, and abuse Required qualifications High School Diploma/GED required Minimum of two years of experience as a Pharmacy Technician National Pharmacy Technician Certification (PTCB or ExCPT) required Knowledge of third-party prescription program claim adjudication Understanding of managed care principles and common medical terminology

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Vacancy posted 2 days ago

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