Pharmacist - RPh Operations Advisor

7am to 10pm CST 8 hours/day
Training: MF 84:30PM CST for 6 weeks
Possible weekend shifts
This is a safety sensitive position.
A broadband connection and a smartphone are required. The VPN token will need to be downloaded to the users smartphone.
Candidates can reside anywhere in the continental U.S. with the exclusion of New Mexico and Colorado.
Active Pharmacy License in state of residence required.
Provide a copy of license with resume

Must ensure the potential new hire understands:
They are required to provide their own highspeed internet.
Minimal home broadband connectivity speed of 25 Mb download and 3 MB upload speed. Speed for home internet can be confirmed by going to
Smartphones are required. The VPN token will need to be downloaded to the users smartphone.
They must have a sufficient/private work area that is used for business during their work hours.
Their current living accommodations are in a stable situation.
Ensure the employee is aware of the Teleworker Privacy Practices they need to abide by.
Workspace is dedicated to Health business during working hours and is not accessible by others who may be present in the household; telephone conversations cannot be overheard, and documents/computer screens cannot be viewed by others.
When not working, the computer is shut off. For short departures from the work area, the workstation must be locked, or the computer shut down.

Intake Call Notes
Top Three Skills
Technical & Computer Proficiency
Comfortable navigating multiple systems simultaneously
Strong Windows proficiency
Ability to learn new technologies quickly
Comfortable utilizing AIassisted productivity tools
Smartphone utilization for VPN access
SelfManagement and Organizational Skills

Able to work independently
Effective prioritization skills
Strong time management
High attention to detail
Successful performance in productionbased environments
Clinical Prior Authorization Review Exp

Questions for top of resuem:
Active Pharmacist License in state of residence
License currently in good standing
Bachelor's Degree in Pharmacy
Minimum 2 years Pharmacist experience
Prior Authorization review experience
Specialty medication experience
Able to complete 22 clinical reviews daily
Able to attend mandatory 6week training with no time off
Smartphone available for VPN
Internet speed screenshot available
Training Commitment Risk
No PTO allowed during first 6 weeks.
Many qualified pharmacists may have preplanned commitments.
Verify before submission.

Duties
This individual must have excellent interpersonal skills. Will be responsible for:
Collaborates with the 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%)
Coordinates timely communication of case decision to physician, healthplan/employer, patient and other healthcare professionals following agreed upon approval & denial management processes. (15%)
Handles inbound phone calls and escalations from physicians or patients regarding Prior Authorization (50%)
Establishes and maintains communication among Caremark, health plan and employer group staff. (5%)
Maintain professional and technical knowledge of drug and diseasestates for the Specialty Medical programs administered within the Novologix. (5%)
Performs other related projects and duties as assigned including on call and after hours pharmacist availability could be required. (5%)

Experience
2%2B 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

Position Summary
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 Caremark supported systems and take inbound calls from physician or members regarding their pending, approved, or denied prior authorizations.

Education
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.
What days & hours will the person work in this position List training hours, if different.
7am to 10pm CST 8 hours/day Training: MF 84:30PM CST for 6 weeks Possible weekend shifts