Pharmacist Operations Advisor

SGS_JOB_2288

Pharmacy
Remote
Pharmacist
RPH
Registered Pharmacist
Prior Authorization
Pharmacy.

Contract - 06+ Months

Shift: Sun-Thu or Tue-Sat 10:30a-7pCT, 11a-7:30pCT, 11:30a-8pCT, and Training M-F 8a-4:30p. A broadband connection and a smartphone are required. The Pharmacist/Clinician is an operation-based role that conducts criteria based & clinical review of medical data collected to perform prior authorization as per policy and procedure. The Pharmacist/Clinician will apply clinical knowledge to plan approved criteria for reviews of cases. This role will work from supported systems and take inbound calls from physicians or members regarding their pending, approved, or denied prior authorizations, internally support the Prior Authorization team and member services department, as well as provide on-call after hours availability for urgent PA requests as needed

Job Responsibilities:

  • Prior experience with prior authorization (PA) reviews or clinical case reviews in a high-volume or production setting—look for direct experience processing PA requests, ideally with commercial or specialty pharmacy, and strong documentation of meeting service level agreements (SLAs) or production targets.
  • Those with Retail experience only – are not excluded and are welcome to apply as we have had many successful applicants from retail.
  • Demonstrated ability to multitask using multiple technology platforms and clinical resources—seek candidates who highlight comfort with multitasking, proficiency with Microsoft Office (especially Excel and Word), and using multiple clinical and administrative systems at once.
  • Strong communication and collaboration skills in cross-functional team prioritize resumes that show effective written and verbal communication, experience working with both clinical and non-clinical staff, and handling phone-based interactions with providers and patients. ;

Skills:

  • EPIC EMR with Ability to take vital signs

Education/Experience:

  • ;Required: Bachelor's Degree - BS Pharmacy and an active pharmacist license in the state of practice/residence and Preferred: Doctorate - Pharm D
  • Sit at desk for long periods of time (up to 100%)
  • Talking on phone for extended periods of time (up to 100%)
  • Computer use for extended periods of time (100%)
  • Reading a computer screen (up to 100%)

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