Pharmacist (R)

Techlink Systems Inc.; Philadelphia (Philadelphia County); Hybrid; USD 85,000 - 120,000; Full time

Job summary

PerformRx in Philadelphia, PA seeks a Pharmacist to determine prior authorization requests for coverage of pharmaceutical products. You will work independently within a team, handling medical necessity and benefit decisions with clinical judgement. The role includes a rotating weekend schedule if needed.

Education requires a Pharmacist license; a PharmD is preferred, with no strict experience requirement. This contract runs until February 15, 2027 and offers on-site work with remote flexibility.

Qualifications

• Bachelor's Degree required; PharmD preferred.
• Current Pharmacist license required.
• Prior Authorization experience preferred.

Responsibilities

• Make determinations on prior authorization requests for coverage of pharmaceutical products.
• Determine medical necessity and benefit decisions according to guidelines and regulations.
• Provide clinical support to customer care and engage with providers to support determinations.
• Stay updated on industry trends, regulatory changes and internal directives.

Skills

Prior Authorization knowledge

PHARMACEUTICAL computer skills

English proficiency

Education

Bachelor's Degree

PharmD preferred

Current Pharmacist license

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 judgement.
• 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