Remote Clinical Pharmacist: Medicaid Prior Authorization

CVS Health; United States; Remote; USD 130,175,000 - 218,201,000; Full time

Job summary

CVS Health is seeking a Clinical Pharmacist to join the Prior Authorization team in a remote role within the United States. The candidate must hold an active North Carolina pharmacist license and have prior authorization experience with Caremark PBM.

Responsibilities include reviewing authorization requests, collaborating with technicians and physicians, maintaining knowledge of Specialty and Non-Specialty programs, and providing after-hours availability as needed.

Qualifications

• Active, unrestricted pharmacist license in good standing in North Carolina.
• Experience with prior authorizations within Caremark PBM.
• Experience using clinical resources such as Micromedex, Lexicomp, Clinical Pharmacology.
• Ability to prioritize and manage multiple tasks in a fast-paced environment.
• Prior authorization, call center and/or clinical pharmacy experience.
• Excellent organizational and communication skills; detail-oriented.

Responsibilities

• Evaluate and review all prior authorization requests and render coverage determinations.
• Collaborate with technicians and team members to process referrals and gather data.
• Maintain knowledge of drugs and disease states for Specialty and Non-Specialty programs.
• Attend training sessions and be available for on-call and after-hours coverage.

Skills

Prior authorizations

Caremark PBM

Clinical resources

MS Office

Communication skills

Independent work

Education

Bachelors of Science - Pharmacy or Pharm.D.

Job description

CVS Health is seeking a Clinical Pharmacist to join the Prior Authorization team in a remote role within the United States. The candidate must hold an active North Carolina pharmacist license and have prior authorization experience with Caremark PBM.

Responsibilities include reviewing authorization requests, collaborating with technicians and physicians, maintaining knowledge of Specialty and Non-Specialty programs, and providing after-hours availability as needed.