Pharmacist (R)

TechLink+; Philadelphia (Philadelphia County); Hybrid; USD 83,000 - 96,000; Full time

Job summary

TechLink+ is seeking a licensed Pharmacist for a contract role in Philadelphia, PA. The Pharmacist will determine prior authorization requests for pharmaceutical coverage, ensuring medical necessity and benefit decisions are aligned with guidelines.

On-site duties with remote flexibility (EST) are available. Responsibilities include clinical support to the customer care center, engaging providers for determinations, and contributing to Fraud and Abuse oversight.

Qualifications

• No experience required; Prior Authorization or Coverage Determination experience preferred.

Responsibilities

• Make determinations on prior authorization requests for pharmaceutical coverage.
• Provide clinical support to the customer care center.
• Engage providers to support determinations.
• Support Fraud and Abuse program oversight.
• Stay current with industry trends and regulatory changes.
• Follow established pharmacy guidelines and regulations.

Skills

Prior Authorization

Coverage Determination

Education

PharmD preferred

Pharmacist license

Tools

Windows PC basics

Job description

Job Title: Pharmacist

Location (On-site, Remote, or Hybrid?): Philadelphia, PA (Remote - EST)

Contract Duration: Contract until 02/15/2027

Duties:

• As a licensed healthcare professional employed in the Prior Authorization Department the primary responsibility of Pharmacist (R) is to make determinations on prior authorization requests for coverage of pharmaceutical products. Determinations include medical necessity and benefit decisions. Decisions are made in accordance with established pharmacy guidelines, prior authorization criteria, industry regulations and sound clinical judgment.
• Prior Authorization Pharmacist (R) works independently with respect to reviews and decision making, with the support of Pharmacist II (R)s and supervisors. Pharmacist (R) works as a member of a team of peers committed to meeting or exceeding quality standards and customer performance guarantees. This position includes a rotating weekend schedule if business needs dictate.

Additional responsibilities include:

• Provide clinical support to the PerformRx Customer Care Center
• Engage providers in discussions to support determinations
• Support Fraud and Abuse program oversight
• Keep abreast of industry trends and regulatory changes
• Keep abreast of operational directives and customer reference materials

EDUCATION:

Bachelor's Degree, PharmD preferred

Current Pharmacist license

SKILLS:

No experience required, Prior Authorization or Coverage Determination experience preferred

Proficient PC skills in a Windows based environment

LANGUAGES:

• English (Read. Write. Speak.)

CERTIFICATIONS & LICENSES:

• Pharmacist license