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A leading healthcare company is seeking a Clinical Staff Pharmacist to process Utilization Management requests. This remote role involves evaluating prior authorization requests and collaborating with healthcare providers. Ideal candidates will hold a PharmD and have at least two years of clinical experience in a fast-paced environment.
Our work matters. We help people get the medicine they need to feel better and live well. We do not lose sight of that. It fuels our passion and drives every decision we make.
Job Posting Title
Clinical Staff Pharmacist- REMOTE
Job Description
The Clinical Staff Pharmacist is responsible for the processing and documenting of Utilization Management requests (i.e. formulary exceptions, prior authorization, step therapy, quantity limit exceptions) for delegated products and services.
Responsibilities
Responsible for the clinical evaluation for coverage determination requests for prior authorization (PA) or other utilization management (UM) programs, including quantity limits, step therapy, formulary exception and tier exception; this includes consideration of the denial language and appropriateness of the decision as it pertains to the clinical content of the case and the intent of the individual client's pre-approved criteria
Accountable for direct consultation with health care providers concerning non-formulary and clinical product coverage issues
Collaborate with team members to promote consistency of decisions across the pharmacist team
Other duties as assigned
Education & Experience
Doctor of Pharmacy (PharmD) or Bachelor of Science Pharmacy Degree
Current pharmacist license in good standing with the State Board of Pharmacy
2 years of clinical experience; or equivalent training, education and/or experience
Must be eligible to work in the United States without the need for work visa or residency sponsorship
Additional Qualifications
Excellent verbal and written communication skills
Ability to work independently and as part of a team
Preferred Qualifications
Managed care experience
Proficiency with Microsoft Office
Physical Demands
This position may require rotation through weekend and/or holiday schedules
Constantly required to sit, use hands to handle or feel, talk and hear
Frequently required to reach with hands and arms
Occasionally required to stand, walk and stoop, kneel, and crouch
Occasionally required to lift and/or move up to 10 pounds and occasionally lift and/or move up to 25 pounds
Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus
Reporting Structure
Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their job, and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.
Potential pay for this position ranges from $51.92 - $88.46 based on experience and skills.
To review our Benefits, Incentives and Additional Compensation, visit our Benefits Page (https://www.primetherapeutics.com/benefits) and click on the "Benefits at a glance" button for more detail.
Prime Therapeutics LLC?is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to?race, color, religion, gender, sex (pregnancy, sexual orientation, and gender identity), national origin, disability, age, veteran status, or any other legally protected class under federal, state, or local law.? ?
We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law.
Prime Therapeutics LLC is a Tobacco-Free Workplace employer.
Positions will be posted for a minimum of five consecutive workdays.
Prime Therapeutics' fast-paced and dynamic work environment is ideal for proactively addressing the constant changes in today's health care industry. Our employees are involved, empowered, and rewarded for their achievements. We value new ideas and work collaboratively to provide the highest quality of care and service to our members.
If you are looking to advance your career within a growing, team-oriented, award-winning company, apply to Prime Therapeutics today and start making a difference in people's lives.
Prime Therapeutics LLC?is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to?race, color, religion, gender, sex (pregnancy, sexual orientation, and gender identity), national origin, disability, age, veteran status, or any other legally protected class under federal, state, or local law.? ?
We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law.
Prime Therapeutics LLC is a Tobacco-Free Workplace employer.
If you are an applicant with a disability and need a reasonable accommodation for any part of the employment process, please contact Human Resources at 1.866.469.1257 or email Careers@primetherapeutics.com.