A-Line Staffing Solutions
Pharmacist - Prior Authorization - Remote
A-Line Staffing Solutions, San Diego, California, United States, 92189
Remote Pharmacist openings with a Major Corporation! Don't miss out on these great opportunities to work from home.
Looking for a stable 40 hours per week to WFH? Have Prior Authorization, adjudication, appeals, denials experience? Hold a Pharmacist license? This is the remote role you're looking for.
Email your resume to Madison Meredith, Staffing Manager II, at mmeredith@alinestaffing.com and follow-up with a text directly to my phone number 469-890-1205.
Training Shift: Monday - Friday 8AM - 430PM (4 weeks) CT Regular Shift: Monday-Friday 9:30AM -6PM local time zone - April Start date!
Title - Pharmacist- Prior Authorization
Pay - $53.00/hr paid bi-weekly. W2 role.
Duties Description
Performs clinical review of prior authorization requests. Utilizes clinical experience and skills in a collaborative process to apply the appropriate clinical criteria/guideline, policy, procedure and clinical judgment to render appropriate coverage determination. Monitors prescribing habits of participating physicians. Makes recommendations to physicians to improve medication regimens as appropriate.
- Improves quality of service to members by developing programs to provide optimal pharmacy care to patients, participating in dispute resolution of drug utilization review, measuring and documenting improvements in patient care, and/or improving claim adjudication for proper provider reimbursement.
- Acts as "subject matter expert" for clinical pharmacy issues (i.e., appeal, fraud, cognitive services, drug reviews, and education). Consults and lends expertise to other internal and external constituents in the coordination and administration of the utilization/benefit management function. Educates providers and staff regarding the appropriate use of pharmaceutical treatment regimens. May develop and maintain training documents for staff development.
- Performs other duties as required
This is a WFH position for candidates with a strong clinical/technical knowledge base and independent problem-solving skills. Pharmacist can have an RPh or Pharm.D degree Must have active license in state you reside in!
#ALINE3
Looking for a stable 40 hours per week to WFH? Have Prior Authorization, adjudication, appeals, denials experience? Hold a Pharmacist license? This is the remote role you're looking for.
Email your resume to Madison Meredith, Staffing Manager II, at mmeredith@alinestaffing.com and follow-up with a text directly to my phone number 469-890-1205.
Training Shift: Monday - Friday 8AM - 430PM (4 weeks) CT Regular Shift: Monday-Friday 9:30AM -6PM local time zone - April Start date!
Title - Pharmacist- Prior Authorization
Pay - $53.00/hr paid bi-weekly. W2 role.
Duties Description
Performs clinical review of prior authorization requests. Utilizes clinical experience and skills in a collaborative process to apply the appropriate clinical criteria/guideline, policy, procedure and clinical judgment to render appropriate coverage determination. Monitors prescribing habits of participating physicians. Makes recommendations to physicians to improve medication regimens as appropriate.
- Improves quality of service to members by developing programs to provide optimal pharmacy care to patients, participating in dispute resolution of drug utilization review, measuring and documenting improvements in patient care, and/or improving claim adjudication for proper provider reimbursement.
- Acts as "subject matter expert" for clinical pharmacy issues (i.e., appeal, fraud, cognitive services, drug reviews, and education). Consults and lends expertise to other internal and external constituents in the coordination and administration of the utilization/benefit management function. Educates providers and staff regarding the appropriate use of pharmaceutical treatment regimens. May develop and maintain training documents for staff development.
- Performs other duties as required
This is a WFH position for candidates with a strong clinical/technical knowledge base and independent problem-solving skills. Pharmacist can have an RPh or Pharm.D degree Must have active license in state you reside in!
#ALINE3