Pharmacist

Lensa; United States; Remote; USD 98,000 - 123,000; Full time

Job summary

A leading healthcare company is seeking a Pharmacist as an RPh Advisor. The role involves supporting Medicare Part D requests, ensuring compliance with guidelines, and delivering high-quality service. Ideal candidates will have a Pharm D, pharmacist license, and experience in healthcare, especially with Medicare and prior authorizations.

Qualifications

• Pharmacist License of Current State required.
• Prior Authorization and Medicare experience necessary.
• Experience in healthcare is helpful.

Responsibilities

• Support Medicare Part D members and providers with pharmacy benefits.
• Review clinical information for decision-making on requests.
• Coordinate communication of case decisions to healthcare professionals.

Skills

Prior Authorization

Medicare

Prior Authorization Call Handling

Education

Bachelor's Degree

Pharm D & Pharmacist License

Job description

15 hours ago Be among the first 25 applicants

Lensa is the leading career site for job seekers at every stage of their career. Our client, US Tech Solutions, is seeking professionals. Apply via Lensa today!

Job Title: Pharmacist

Location: Remote

Duration: 12+ months contract

Job Description

• As an RPh Advisor you will be directly supporting Medicare Part D members and providers with requests related to their pharmacy benefits. You will be responsible for ensuring cases are accurately set up for our members, review clinical information for decisioning the request, performing outreach to providers for more information when needed, and ensuring accurate decisions that comply with compendia and Medicare guidance and timelines. This is a great opportunity to initiate a career with a leading healthcare company by reviewing information and completing timely and accurate documentation of all Medicare Part D requests, in compliance with Medicare guidelines, while promoting a best-in-class service experience.
  
  

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 health plan/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%)
  
  

Experience

• Pharmacist License of Current State
• Prior Authorization Experience.
• Medicare Experience
• Experience working in healthcare.
  
  

Skills

• Prior Authorization.
• Medicare.
• Prior Authorization Call Handling.
  
  

Education

Bachelor's Degree Required, Pharm D & Pharmacist License of Current state you are residing.

About US Tech Solutions

US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions. To know more about US Tech Solutions, please visit www.ustechsolutions.com (http://www.ustechsolutionsinc.com) .

US Tech Solutions is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity,

national origin, disability, or status as a protected veteran.

If you have questions about this posting, please contact [e-mail]

Seniority level

• Seniority level

  Entry level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Health Care Provider

• Industries

  IT Services and IT Consulting

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