Remote Prior Authorization Pharmacist - Utilization & PDL

Gainwell Technologies; Oregon City (OR); Remote; USD 91,000 - 130,000; Full time

Benefits offered by this job

Flexible vacation policy

401(k) employer match

Health benefits

Educational assistance

Job summary

Gainwell Technologies is seeking a Prior Authorization Pharmacist to review PA requests from medical professionals and ensure alignment with PD List criteria and current clinical guidelines. The PA pharmacist will work with internal and external stakeholders in evaluating and continually developing a strategy for Utilization Management.

Ideal candidates hold a PharmD or B.S. in Pharmacy, a valid state license, and at least four years of clinical pharmacy experience.

Qualifications

• Pharmacist with PharmD or B.S. in Pharmacy.
• Active pharmacist licensure in applicable state.
• Minimum 4 years of clinical pharmacy experience.
• Excellent verbal and written communication skills.
• Experience with managed care or prior authorization is a plus.

Responsibilities

• Review PA requests to ensure PD List criteria and guidelines.
• Support Peer to Peer discussions with providers.
• Contribute to script refinement and gather user feedback.
• Assist with communications to members and physicians.
• Contribute to continuous quality improvement with product leaders.
• Maintain up-to-date clinical knowledge and guidelines.

Skills

Strong verbal and written communi-c at

Microsoft Office proficiency

Education

PharmD or B.S. in Pharmacy

Registered Pharmacist with unrestricted State Licensure

Tools

Proprietary systems

Microsoft Office

Job description

Gainwell Technologies is seeking a Prior Authorization Pharmacist to review PA requests from medical professionals and ensure alignment with PD List criteria and current clinical guidelines. The PA pharmacist will work with internal and external stakeholders in evaluating and continually developing a strategy for Utilization Management.

Ideal candidates hold a PharmD or B.S. in Pharmacy, a valid state license, and at least four years of clinical pharmacy experience.