Title: Prior Authorization Pharmacist (R)Location : Remote - ESTContract Length: 13 Weeks (Possible Extension)Shift: EST / (8hrs.*5 days) Business HoursJob Summary: We are seeking a licensed Pharmacist to join our Prior Authorization Department. The Pharmacist will review prior authorization requests, make coverage and medical-necessity determinations, and ensure decisions align with clinical guidelines, regulations, and established criteria.Job Duties:
Requirements:
- Review and process prior authorization requests for pharmaceutical products.
- Make medical necessities and benefit determinations using established criteria and pharmacy guidelines.
- Provide clinical support to the Perform Rx Customer Care Center.
- Communicate with providers to obtain information and support appropriate determinations.
- Support Fraud and Abuse program oversight and related clinical activities.
- Stay current with industry trends, regulatory changes, operational directives, and customer-specific reference materials.
Requirements:
- Active Pharmacist license
- PharmD or equivalent pharmacy qualification.
- Recent 1 year of Prior Authorization or Coverage Determination experience is required.
- Flexibility to work a rotating weekend schedule if required by business needs.
Pharmacist (R) in philadelphia at Unknown Company
This position is listed as contract and able to be worked remotely.