PA Pharmacist

Job Description

The Prior Authorization (PA) Pharmacist is responsible for reviewing prior authorization requests from providers to ensure safe and effective medication utilization. The PA pharmacist will work with internal and external stakeholders in evaluating and continually developing a strategy for Utilization Management.
Essential Job Functions
• Review Prior Authorization requests from medical professionals to ensure alignment with Preferred Drug List (PDL) criteria and current clinical guidelines
• Support Peer to Peer discussions with medical providers to discuss Prior Authorization reviews
• Collaborates on the refinement of consultation scripting; solicits and utilizes input from those contacted toward scripting improvements
• Contributes to the success of the Clinical Call Centers and Prior Authorization department by assisting with the implementation and management of both written and verbal communications to members and physicians. Is available for consultation on pharmacy-related questions and issues for others within the organization
• Upholds clinical integrity of pharmaceutical solutions by staying up to date on medication information, clinical guidelines, contributing to the identification of pharmacy program best practices, and collaborating with Medical Directors, Clinical Pharmacist, and Clinical Pharmacist to provide pharmacy expertise
• Collaborate internally with pharmacy team (Pharmacy Manager, PDL Coordinator, Clinical Pharmacists) to identify trends or areas to explore with the intent of identifying new drugs and therapeutic classes needing utilization management
• Other duties as assigned
Requirements
• PharmD or B.S. in Pharmacy with relevant Specialty background
• Registered Pharmacist with unrestricted respective State Licensure (Connecticut Pharmacist License Preferred but not required)
• 4 years’ experience in clinical pharmacy
• Strong verbal and written communications skills
• Highly skilled with Microsoft Office products and ability to quickly learn proprietary systems