Pharmacist – Coverage Determinations & Appeals

Apex Systems; Solon (OH); On-site; USD 100,000 - 120,000; Full time

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

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.