Job description

Clinical Pharmacist Medicare D - 12 Months Contract - Remote

Description:

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 Medicare D cases. This role will work from supported systems and make outbound calls to physician or members regarding their pending, approved, or denied prior authorizations. This is a production environment with production and quality goals on set ramp targets.

Responsibilities

· Collaborates with multiple groups within CD&A, including answering clinical questions, collecting appropriate clinical/ medical data needed to perform clinical assessments, and reviews as per the healthplan/employer agreed criteria within the designated service level agreements. (20%)

· Coordinates timely communication of case decision to physician, health-plan/employer, patient and other healthcare professionals following agreed upon approval & denial management processes. (20%)

· Reviews cases in progress and provides a Clinical decision regarding Prior Authorizations, Tier Exceptions and Non-Formulary requests (50%)

· Performs other related projects and duties as assigned including on call and after hours pharmacist availability could be required. (10%)

· Knowledge of Access, Power Point, and Visio is preferable.

· Licensed Registered Pharmacist in state of residence

· Bachelors Degree Required, Pharm D Preferred

Job Type: Contract

Pay: $49.00 - $53.00 per hour

Schedule:

• 8 hour shift

Education:

• Bachelor's (Required)

Experience:

• Medicare: 3 years (Required)

Work Location: Remote

www.colinoncars.com is the go-to platform for job seekers looking for the best job postings from around the web. With a focus on quality, the platform guarantees that all job postings are from reliable sources and are up-to-date. It also offers a variety of tools to help users find the perfect job for them, such as searching by location and filtering by industry. Furthermore, www.colinoncars.com provides helpful resources like resume tips and career advice to give job seekers an edge in their search. With its commitment to quality and user-friendliness, www.colinoncars.com is the ideal place to find your next job.