Pharmacist

Apex Systems

Solon (OH)

On-site

USD 100,000 - 120,000

Full time

14 days+

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Job summary

An IT staffing and services firm is seeking a Pharmacist responsible for reviewing clinical coverage determinations and appeals. The role requires an active Pharmacist License in Ohio and offers a flexible schedule, including nights and weekends. Candidates must have proficiency in Microsoft Office applications. Join a team committed to meeting business objectives while maintaining quality decision-making in patient care.

Qualifications

A minimum of 6 months experience as a Pharmacist is required.
Must hold an active license to practice in the state of Ohio.

Responsibilities

Review clinical coverage determination and appeals using Medicare requirements.
Perform data analysis and manage medication exception requests.
Utilize web-based tools for information review and research.
Engage in outreach for additional information from stakeholders.
Enter and record decisions and clinical notations in electronic databases.

Skills

High proficiency in Microsoft Word

High proficiency in Microsoft Excel

Effective communication skills

Data entry skills

Education

Active Pharmacist License in Ohio

Job description

Apex Systems LLC, a division of On Assignment, is an IT staffing and services firm specializing in providing IT professionals for contract, contract-to-hire, and direct placements. Apex also offers recruitment solutions for other select professional skills and workforce needs

Job Description

Hours of Operation for the site: currently 7:00am - 7:30pm EST. workers will have one of the following shifts: following shifts (subject to change): 7:00am-3:30pm, 8:00am-4:30pm, 9:00am-5:30pm, 10:00am-6:30pm, 11:00am-7:30pm, OT typically voluntary based on volume of work, sometimes mandatory

Position Summary: Responsible for reviewing clinical coverage determination and appeals using Medicare and client specific requirements. Knowledgeable in all aspects of coverage determination and appeals process and assist in meeting clients expectations regarding efficiency, services levels, privacy maintenance and quality decision making. Work as part of the team to meet business unit objectives. The Pharmacist will be responsible for reviewing medication exception request, as well as completing data analysis and various clinical projects. Escalate issues to Coverage Determinations and Appeals management team as needed. Position will require schedule flexibility including rotations through nights, weekend and holiday coverage. All other duties are required to meet business needs.

Duties

Review the information provided upon request by utilizing the designated tools (web based) for further research. High proficiency in computer skills is necessary including but not limited to Microsoft Word, Microsoft Excel, and web based programs. (60%)
Outreach for additional information. May include Pharmacy, Prescribers, Members, etc. as appropriate. (25%)
Data Entry (Electronic Database) recording decision making, inputting clinical notation, request for additional information, faxes, summary, etc. (10%)
Training - attending meetings, online job aides, process changes, new initiatives, communication, etc. both formal and informal training. (5%)

Qualifications