Supervising a team of appeal pharmacists, the full-time salaried North Carolina Licensed Appeals Pharmacist will oversee prior authorization processes, manage compliance risks, and provide training while working remotely. Key responsibilities Supervise appeal pharmacists and technicians, ensuring compliance with prior authorization operations Analyze data to recommend staffing and workflow enhancements for prior authorization processes Conduct clinical pharmacy functions including prior authorization and appeal reviews, and manage escalated issues Required qualifications Doctor of Pharmacy (Pharm.D.) or Bachelor of Pharmacy degree from an accredited program Active unrestrictive pharmacist license 2 years of experience as a clinical pharmacist in a Pharmacy Benefit Management (PBM) setting 1+ year of experience with Commercial and/or Medicare appeals Strong understanding of pharmacy benefit management processes, including claims processing and prior authorization
Pharmacist in workfromhome at Unknown Company
This position is listed as full time and able to be worked remotely.