State Licensed PBM Pharmacist

Job Summary

A company is looking for a Pharmacist- Prior Authorization.

Key Responsibilities

• Perform clinical review of prior authorization requests and apply clinical criteria for coverage determination
• Develop programs to enhance pharmacy care, participate in dispute resolution, and document improvements in patient care
• Act as a subject matter expert on clinical pharmacy issues and educate providers and staff on pharmaceutical treatment regimens

Required Qualifications

• Must possess an active pharmacist license in the state of residence
• Holds either an RPh or Pharm.D degree
• Prior experience in a PBM setting, specifically with prior authorization
• Strong clinical and technical knowledge base
• Ability to work independently and demonstrate problem-solving skills