Prior Authorization Pharmacist – Independent Review & Collaboration

TALENT Software Services; Philadelphia (Philadelphia County); On-site; USD 90,000 - 120,000; Full time

Job summary

TALENT Software Services seeks a licensed healthcare professional to join the Prior Authorization Department in the Philadelphia area. The role centers on determining coverage for pharmaceutical products, including medical necessity and benefit decisions, with oversight from Pharmacist II (R)s and supervisors.

You will work as part of a team dedicated to quality standards and customer performance, with a rotating weekend schedule as needed to meet business demands.

Qualifications

• Licensed healthcare professional acting in Prior Authorization decisions.
• Must be able to evaluate medical necessity and benefit coverage.

Responsibilities

• Make determinations on prior authorization requests for coverage of pharmaceutical products.
• Determine medical necessity and benefit decisions.
• Follow pharmacy guidelines, POA criteria, regulations, and clinical judgment.

Skills

Prior Authorization

Windows Proficiency

Job description

TALENT Software Services seeks a licensed healthcare professional to join the Prior Authorization Department in the Philadelphia area. The role centers on determining coverage for pharmaceutical products, including medical necessity and benefit decisions, with oversight from Pharmacist II (R)s and supervisors.

You will work as part of a team dedicated to quality standards and customer performance, with a rotating weekend schedule as needed to meet business demands.