Remote Clinical Pharmacist Prior Authorization

Greenkey Resources LLC; Durham (NC); Remote; USD 110,000 - 140,000; Full time

Job summary

Greenkey Resources LLC is seeking a Clinical Pharmacist to review prior authorization requests, ensuring coverage aligns with member benefits and criteria. The role emphasizes maintaining up-to-date drug knowledge and providing clinical guidance to pharmacy technicians, with a focus on compliance and quality standards.

The position supports remote work arrangements, requires analyzing utilization review data, and collaboration with Pharmacy and Therapeutics committees to optimize benefit designs

Qualifications

• PharmD degree required.
• Active state pharmacy license.
• Minimum 3 years in a related field; 5 years preferred.
• Proficiency with drug coding and claims adjudication systems.
• Experience with remote work environments.

Responsibilities

• Review prior authorization requests for drug products and ensure compliance.
• Analyze utilization review data and summarize findings for reporting.
• Track compliance and implement quality control measures.
• Provide clinical guidance and mentorship to pharmacy technicians.
• Collaborate with committees to review guideline criteria for prior authorization.
• Evaluate opportunities for performance improvement in pharmacy practices.
• Ensure compliance with corporate standards and contribute to benefit designs.

Skills

Analytical skills

Remote work experience

Drug coding

Mentorship

Education

PharmD degree

Tools

NDC

GCN

GPI

USC

Job description

Greenkey Resources LLC is seeking a Clinical Pharmacist to review prior authorization requests, ensuring coverage aligns with member benefits and criteria. The role emphasizes maintaining up-to-date drug knowledge and providing clinical guidance to pharmacy technicians, with a focus on compliance and quality standards.

The position supports remote work arrangements, requires analyzing utilization review data, and collaboration with Pharmacy and Therapeutics committees to optimize benefit designs