Remote Utilization Management Pharmacist (PA Adjudication)

Career Opportunities; United States; Teletrabalho; USD 111 000 - 150 000; Tempo integral

Resumo da oferta

TruDataRx, Inc. seeks a Clinical Pharmacist I to join a fast-paced, virtual team focused on clinical adjudication of initial prior authorization requests. You will evaluate medical necessity and apply plan criteria with evidence-based data to ensure timely determinations.

The role emphasizes collaboration with the Pharmacy Support Specialist team, remote productivity, and strict adherence to regulatory standards. A PharmD with an active license is required.

Qualificações

• Strong foundational clinical skills for evaluating complex data.
• Ability to produce high-volume, accurate adjudications in a virtual setting.
• Meticulous attention to plan criteria, compliance parameters, and workflows.

Responsabilidades

• Evaluate and adjudicate initial PA requests against clinical criteria and protocols.
• Apply plan-specific criteria, guidelines, and regulatory standards for timely determinations.
• Navigate clinical drug databases to analyze indications, dosages, and parameters.

Conhecimentos

Clinical Acumen

Remote Productivity

Process-Oriented

Communication Excellence

Formação académica

Doctor of Pharmacy (PharmD)

Active pharmacist license

Ferramentas

Medi-Span

First Databank

Descrição da oferta de emprego

TruDataRx, Inc. seeks a Clinical Pharmacist I to join a fast-paced, virtual team focused on clinical adjudication of initial prior authorization requests. You will evaluate medical necessity and apply plan criteria with evidence-based data to ensure timely determinations.

The role emphasizes collaboration with the Pharmacy Support Specialist team, remote productivity, and strict adherence to regulatory standards. A PharmD with an active license is required.