Pharmacist

Hicks Professional Group (HPG); California (MO); On-site; USD 90,000 - 120,000; Full time

Job summary

Hicks Professional Group (HPG) is seeking a healthcare professional in California to support clinical and operational implementation of formulary policies for both Commercial and Medicare lines.

Role involves applying clinical expertise to prior authorization reviews, collaborating with PA and Call Center teams, and ensuring timely review within regulatory standards. Strong knowledge of outpatient medications and AuthAccel experience are preferred.

Qualifications

• Must be licensed in California (non-restricted).
• Must be located in California.

Responsibilities

• Support the clinical and operational implementation of P&T approved policies for the pharmacy benefit across Commercial and Medicare lines.
• Apply clinical expertise to PA reviews and collaborate with the PA and Call Center Teams to support access to safe, efficacious, and medically necessary medications.
• Operate in compliance with regulatory and accreditation requirements to ensure requests are reviewed within required timeframes.
• Serve as a resource regarding the drug formulary, medication policies and appropriate drug use for internal and external constituents.
• Answer clinical and operational questions, participate in group discussions, and support team members toward collective goals.
• Communicate clearly and on-brand when communicating with providers or members.
• Follow all corporate policies and procedures.

Skills

Prior authorization

Outpatient meds knowledge

AuthAccel experience

Job description

Must be licensed in the state of California (non-restricted)

Must be located in California

Duties:

• Support the clinical and operational implementation of P&T approved policies for the pharmacy benefit, for both the Commercial and Medicare lines of business
• Apply clinical expertise to PA reviews and work collaboratively with the PA and Call Center Teams to support access to safe, efficacious, and medically necessary medications
• Operate in compliance with all regulatory and accreditation requirements to ensure all requests are reviewed within regulatory required timeframes
• Serve as a resource to internal and external constituents regarding the drug formulary, medication policies and appropriate drug use
• Answering clinical and operational questions, participating in group discussions, and supporting other team members while working towards a collective goal
• Use clear and concise communications and on-brand messaging when communicating with providers or members
• Follow all corporate policies and procedures
• Operate in compliance with all regulatory and accreditation requirements, and corporate policies and procedures regarding the support access to safe, efficacious, and medically necessary medications

Skills Needed:

• Previous experience in prior authorization review
• Thorough knowledge of therapeutic use of outpatient medications
• Prior experience with AuthAccel preferred.