Clinical Utilization Pharmacist - Remote Management Expert

Point32Health; Canton (MA); Hybrid; USD 110,680 - 166,020; Full time

Benefits offered by this job

Medical, dental, and vision coverage

Tuition program

Paid time off

Job summary

Point32Health is looking for a Clinical Pharmacist to manage pharmacy prior authorization requests. This role involves reviewing cases, communicating with healthcare providers, and ensuring compliance with regulatory standards.

The ideal candidate will hold a PharmD or equivalent and have at least 3 years of pharmacy experience. Benefits include health coverage, retirement plans, and a tuition program.

Qualifications

• Minimum 3 years full-time experience as a pharmacist in a managed care setting.
• Current registration and good standing with the Board of Pharmacy.
• Certification by the Board of Pharmacy Specialties in a relevant area preferred.

Responsibilities

• Review and manage daily caseload of pharmacy prior authorization requests.
• Communicate daily with members and providers regarding case status.
• Provide clinical support for prior authorization requests.

Skills

Analytical ability

Excellent written and verbal communication

Strong PC skills

Organizational skills

Education

Bachelor of Science in Pharmacy or PharmD

Licensed to practice pharmacy in Massachusetts

Tools

MS Office

NCPDP claims adjudication systems

Job description

Point32Health is looking for a Clinical Pharmacist to manage pharmacy prior authorization requests. This role involves reviewing cases, communicating with healthcare providers, and ensuring compliance with regulatory standards.

The ideal candidate will hold a PharmD or equivalent and have at least 3 years of pharmacy experience. Benefits include health coverage, retirement plans, and a tuition program.