Remote Appeals Pharmacist: Fair Medication Access

Pharmacy Careers; Kansas City (MO); À distance; USD 110 000 - 140 000; Plein temps

Avantages offerts par ce poste

Comprehensive benefits

Remote or hybrid options

Advancement opportunities

Résumé du poste

Pharmacy Careers is seeking a Remote Appeals Pharmacist to review medication coverage appeals from home, applying evidence-based guidelines and regulatory requirements to reach fair determinations. This role emphasizes strong clinical writing and collaboration with physicians and medical directors.

We offer fully remote or hybrid options, a competitive salary, comprehensive benefits, and growth opportunities in managed care and appeals.

Qualifications

• Education: PharmD or Bachelor of Pharmacy.
• Experience: Managed care or utilization management preferred.
• Skills: Excellent clinical judgment, written communication, and regulatory attention to detail.

Responsabilités

• Review clinical documentation for medication coverage appeals and grievances.
• Apply plan policies, evidence-based guidelines, and regulatory requirements to reach determinations.
• Prepare clear written clinical rationales supporting appeal outcomes.
• Collaborate with physicians, nurses, and medical directors during case reviews.
• Track and report appeal outcomes in full compliance with state and federal rules.
• Contribute to process improvements that enhance timeliness and quality.

Connaissances

Clinical judgment

Written communication

Regulatory attention to detail

Formation

PharmD or Bachelor of Pharmacy

Description du poste

Pharmacy Careers is seeking a Remote Appeals Pharmacist to review medication coverage appeals from home, applying evidence-based guidelines and regulatory requirements to reach fair determinations. This role emphasizes strong clinical writing and collaboration with physicians and medical directors.

We offer fully remote or hybrid options, a competitive salary, comprehensive benefits, and growth opportunities in managed care and appeals.