Job Summary
A company is looking for a Clinical Pharmacist - Prior Authorization.
Key Responsibilities
- Collaborate with team members to process referrals and perform clinical assessments based on health plan criteria
- Evaluate prior authorization requests, render coverage determinations, and verify insurance eligibility
- Communicate decisions regarding cases to healthcare providers, patients, and other stakeholders efficiently
Required Qualifications
- 2 years of experience as a pharmacist in a PBM setting
- Current experience with commercial Prior Authorizations in PBM
- Active pharmacist license in good standing in the state of residence
- Experience using clinical resources such as Micromedex and Lexicomp
- Bachelor's of Science in Pharmacy or Pharm.D
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