Immediate need for a talented Clinical Pharmacist. This is a 06+months contract opportunity with long-term potential and is located in NC(Remote). Please review the job description below and contact me ASAP if you are interested.
Job ID: 26-14274
Pay Range: $58/hr - $60/hour. Employee benefits include, but are not limited to, health insurance (medical, dental, vision), 401(k) plan, and paid sick leave (depending on work location).
Key Responsibilities:
- Review prior authorization requests and make determinations for drug products according to member benefits and coverage criteria
- Report to utilization review statistics to corporate compliance committees
- Review data and summarize daily utilization review numbers
- Responsible for tracking compliance of review cases
- Provide clinical guidance and support to the assigned pharmacy technicians
- Knowledge of drug coding (NDC, GCN, GPI and USC) and NCPDP claims adjudication systems
- Review guideline criteria for prior authorization and non-formulary drugs in support of Pharmacy and Therapeutics Committee function and pharmacy benefit design.
- Ensure and evaluate quality controls and implement opportunities for performance improvement in pharmacy practices
- Research drug information to maintain drug knowledge and disease state understanding for application to prior authorization reviews Hiring Requirements
Key Requirements and Technology Experience:
- Key skills; Must have Clinical Pharmacist License for NC.
- Bachelor''s degree or advanced degree
- 3+ years of experience in related field.
- Current states pharmacy license.
- Industry Specific : Retail, HMO, DSNIP
- Able to work on computer and has work from home experience + Pharmacist experience + High volume calling experience
- Medicare and Medicaid experience, Health Plan managed care experience MTM/CMR
- Typical Day : Participating in comprehensive medication review. Cold calling members and reaching out on non-adherence.
- Advocate for member on adherence gaps.
- Time that you will be on the phone is going to be 3.5 to 4.5 hours a day
Our client is a leading Healthcare Industry, and we are currently interviewing to fill this and other similar contract positions. If you are interested in this position, please apply online for immediate consideration.
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