Remote Pharmacist I - Clinical Prior Authorization

Navitus; Topeka (KS); On-site; USD 110,000 - 140,000; Full time

Benefits offered by this job

Health, Dental, and Vision insurance

Paid time off

Parental leave

Holidays

401K company match

Adoption Assistance

Flexible Spending Account

Educational Assistance

Referral Bonus Program

Job summary

Navitus Health Solutions is hiring a Pharmacist I, Clinical Prior Authorization to perform prior authorizations, drug utilization reviews, and support for clinical calls requiring pharmacist intervention.

You will interface with physicians, pharmacists, and specialty providers to review benefits and therapeutic interventions, and assess health surveys and utilization data for program management.

Qualifications

• Bachelor’s degree in Pharmacy or PharmD and active pharmacist licensure.
• Two years’ clinical or managed care experience preferred.
• Knowledge of PBM, formulary management, and pharmacy claims is desirable.
• Excellent clinical judgment and ability to translate information for clinical systems.

Responsibilities

• Support and input to clinical programs such as Health Management and Prior Authorization.
• Review coverage determinations and provide pharmacist-driven input.
• Monitor quality and efficiency of Coverage Determination processes.
• Contribute to clinical content of new and existing programs.
• Complete URAC training requirements.

Skills

Clinical judgment

Pharmacy knowledge

Drug utilization review

Communication with physicians

Policy interpretation

Education

Bachelor’s degree in Pharmacy or PharmD

Tools

MS Word

MS Excel

PowerPoint

Job description

Navitus Health Solutions is hiring a Pharmacist I, Clinical Prior Authorization to perform prior authorizations, drug utilization reviews, and support for clinical calls requiring pharmacist intervention.

You will interface with physicians, pharmacists, and specialty providers to review benefits and therapeutic interventions, and assess health surveys and utilization data for program management.