Providing telephonic clinical support, the full-time California Licensed Pharmaceutical Nurse will manage healthcare provider interactions, conduct clinical reviews for prior authorizations, and facilitate patient access to medications while working remotely. Key responsibilities Conduct telephonic support and clinical reviews for healthcare providers regarding payer coverage criteria and prior authorization submissions Analyze complex reimbursement issues, troubleshoot cases, and communicate effectively with stakeholders to resolve escalated issues Gather and prepare data for Quarterly Business Reviews and participate in program-specific customer meetings and training sessions Required qualifications Associate degree and a valid Registered Nurse License in California, with willingness to obtain additional state licenses as needed Minimum of 2 years' experience in a customer service role, preferably in a call center or healthcare setting Proficient in Microsoft Office applications, particularly Excel Experience in the PBM and/or healthcare industry Strong analytical skills with the ability to prepare reports and document clearly
California Licensed Pharmaceutical Nurse in workfromhome at Unknown Company
This position is listed as full time and able to be worked remotely.