Licensed Prior Authorization Pharmacist

Job Summary

A company is looking for a Prior Authorization Systems Pharmacist to support the development and maintenance of clinical criteria and prior authorization system configurations.

Key Responsibilities

• Build decision trees and question sets for prior authorization review
• Write utilization management criteria policies based on clinical guidelines
• Manage prior authorization self-service functions and configurations for compliance

Required Qualifications

• Active, unrestricted pharmacist license
• Bachelor's or Doctor of Pharmacy degree
• 2+ years of prior authorization review experience required
• Experience managing clinical criteria strongly preferred
• Formulary experience preferred