Prior Authorization Pharmacist – LTC & Hospice Access

SpecialtyRx, Inc; Morton Grove (IL); On-site; USD 100,000 - 140,000; Full time

Benefits offered by this job

Health insurance

Dental insurance

Vision insurance

Group life insurance

Job summary

SpecialtyRx, Inc. in Illinois seeks a knowledgeable Prior Authorization Pharmacist to join our Long-Term Care Pharmacy team.

You will review coverage requirements, support prior authorization submissions, and ensure timely access to medications for patients in long-term care facilities and hospice settings. The ideal candidate has strong clinical judgment, familiarity with Medicare Part D and payer guidelines, and experience with prior authorizations and insurance processes.

Qualifications

• Pharm.D. or B.S. in Pharmacy from an accredited institution.
• Active Illinois pharmacist license in good standing.
• Experience with prior authorizations and insurance billing preferred.

Responsibilities

• Review medication orders for coverage requirements and prior authorization criteria.
• Prepare, submit, and follow up on prior authorization requests with payers.
• Resolve insurance claim rejections and coordinate with prescribers and facilities.

Skills

Attention to detail

Communication

Critical thinking

Teamwork

Education

Doctor of Pharmacy (Pharm.D.) or BS in Pharmacy

Tools

Pharmacy management systems

Job description

SpecialtyRx, Inc. in Illinois seeks a knowledgeable Prior Authorization Pharmacist to join our Long-Term Care Pharmacy team.

You will review coverage requirements, support prior authorization submissions, and ensure timely access to medications for patients in long-term care facilities and hospice settings. The ideal candidate has strong clinical judgment, familiarity with Medicare Part D and payer guidelines, and experience with prior authorizations and insurance processes.