Title: Clinical Pharmacist
Duration: 10 months (Temp to perm?)
Location: The role is 100% remote, but candidates need to be from an approved conversion State (Alabama, Arizona, Arkansas, Colorado, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Michigan, Mississippi, Missouri, North Carolina, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Wisconsin, and Wyoming.)
Shift Timing: M-F 8am - 5pm

Job Description:

• 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:

• Bachelor's degree or advanced degree.
• 3+ years of experience in related field.
• Current states pharmacy license.

Top 3-4 Required Skills:

• Able to work on computers and has work from home experience Pharmacist experience.

Nice to have Skills: 

• Medicare and medicade experience

Years of Experience:

• 3-5

Breakdown of Duties/Typical Day:

• Comprehensive case reviews.
• They will review the medicine that a customer is on and help them be able to review the medicine a customer is having.
• The worker will not be tied to a queue, they will be making outbound as well as inbouding calls.
• Calls will be recorded and audited for quality check.

 
 
At SPECTRAFORCE, we are committed to maintaining a workplace that ensures fair compensation and wage transparency in adherence with all applicable state and local laws. This position’s starting pay is: $ 61.80/hr.