Prior Authorization Clinical Pharmacist

WellDyne; United States; Remote; USD 99,000 - 129,000; Full time

Job summary

A leading pharmacy company seeks an experienced clinical pharmacist to review prior authorizations and support pharmacy operations. This role requires strong clinical decision-making skills, effective communication, and the ability to work in a remote environment, catering to a diverse client base with compliance and confidentiality as priorities. Benefits include medical, dental, vision, and 401K.

Benefits

Medical, Dental and Vision Benefits

401K after 90 days of employment

Educational Reimbursement

Paid Time Off

Qualifications

• Minimum of two years pharmacy experience required.
• Ability to become licensed in multiple states as required.
• Familiarity with Microsoft Word, Excel, and Outlook preferred.

Responsibilities

• Accountable for decision-making for clinical pharmacy reviews.
• Responsible for formulary development and clinical programs.
• Assist in training and developing pharmacy personnel.

Skills

Communication

Teamwork

Clinical Decision-Making

Education

Licensed Pharmacy Degree

Drug Information background

Job description

Summary
Under the direction of the Manager, Clinical Services, practice in accordance with local, state, and federal rules and regulations. Handle the clinical review process for Prior Authorizations as it pertains to retail clients of WellDyne.

Essential Duties and Responsibilities

• Accountable for decision-making for clinical pharmacy reviews, questions from Account Teams and PA support staff, as well as maintaining a comprehensive library of clinical forms for use by the team.
• Responsible for participating in formulary development, pharmacy service-related processes, and clinical programs in accordance with company policy and to promote a positive customer experience.
• Responsible for practicing in accordance with local, state, and federal rules and regulations.
• Contribute to and support an atmosphere of effective teamwork.
• Attend pertinent meetings when necessary.
• Assist in training and developing other pharmacy personnel.
• Follow and aid in enforcement of all company policies and procedures.
• Responsible for keeping abreast of developments in the professional field.
• Respect and maintain confidentiality guidelines of HIPAA.
• Answer clinical drug information questions as requested.

Education and Experience

• Ability to become licensed in multiple states as required.
• Two years minimum of pharmacy experience
• Familiarity with Microsoft Word, Excel, and Outlook
• Drug Information background preferred

Knowledge, Skills, and Abilities

• Ability to communicate effectively, patiently, and courteously.
• Ability to handle multiple activities or interruptions at once.
• Focused team player, who can work in conjunction with pharmacists, other departments, customers, and management.
• Work independently and make clinical decisions with little supervision and meet daily deadlines.

Remote Work Requirements

• To ensure effective performance in a remote environment, all candidates must meet the following technical and workspace requirements:
• Internet Speed: Minimum of 100 Mbps download / 10 Mbps upload, verified by HR through a speed test
• Connectivity: Must be able to connect using a hard-wired Ethernet connection (modem/router must be within 10 feet to allow for a wired setup)
• Phone Access: A mobile device is required to receive VPN push notifications and for system support
• Workspace: A dedicated, quiet workspace that minimizes background noise and distractions

WellDyne Can Offer You

• Medical, Dental and Vision Benefits
• Medical Savings Account Options with Company match
• 401K after 90 days of employment
• Employee Assistance Program
• Life and Supplemental insurance
• Educational Reimbursement
• Paid Time Off
• Career Pathing

Base Salary Range: $99,000.00-129,000.00
In accordance with applicable state and federal laws, the range provided is WellDyne's reasonable estimate of the base compensation for this role. The actual amount may differ based on non-discriminatory factors such as experience, knowledge, skills, abilities, and location. Base pay is one part of the total package that is provided to compensate and recognize employees for their work, and this role may be eligible for additional discretionary bonuses/incentives, and equity in the Company.

Work Environment / Physical Demands
This position is in a typical office environment which requires prolonged sitting in front of a computer. Requires hand-eye coordination and manual dexterity sufficient to operate standard office equipment including operation of standard computer and phone equipment.

EOE M/F/D/V