Clinical Pharmacist 1
Spectraforce
US
Remote
2 hours ago
Job Description
Title: Clinical Pharmacist 1
Location: Remote
Duration: 6 Months - Possible extension
10am – 6:30pm EST, OT possible
Responsibilities
This team reviews medication prior authorization requests and coverage determinations for the Medicaid, Medicare and Health Exchange lines of business.
?A typical day consists of reviewing 140 to 160 clinical prior authorizations or coverage determiantions• Develop clinical criteria for medications, recommend plan design changes, and clinical programs to be initiated
• Monitor prior authorization requests
• Provide clinical support to internal departments and address clinical related questions
• Ensure appropriate quality controls and initiates opportunities for performance improvement in pharmacy/practice
• Develop and implement programs designed to impact DUR for both Medicaid and Medicare
• Develop, implement, and maintain policies and procedures for the pharmacy department
• Participate in the coordination of the Medicare MTM program
• Assist case management team with members including clinical rounds presentations
Position is offered by a no fee agency.
Location : Remote
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: $58.00/hr.
Location: Remote
Duration: 6 Months - Possible extension
10am – 6:30pm EST, OT possible
Responsibilities
This team reviews medication prior authorization requests and coverage determinations for the Medicaid, Medicare and Health Exchange lines of business.
?A typical day consists of reviewing 140 to 160 clinical prior authorizations or coverage determiantions• Develop clinical criteria for medications, recommend plan design changes, and clinical programs to be initiated
• Monitor prior authorization requests
• Provide clinical support to internal departments and address clinical related questions
• Ensure appropriate quality controls and initiates opportunities for performance improvement in pharmacy/practice
• Develop and implement programs designed to impact DUR for both Medicaid and Medicare
• Develop, implement, and maintain policies and procedures for the pharmacy department
• Participate in the coordination of the Medicare MTM program
• Assist case management team with members including clinical rounds presentations
| Candidate Requirements | ||||
| Education/Certification | Required: Bachelors / PharmD | Preferred: | ||
| Licensure | Required: Current states pharmacist license | Preferred: | ||
| Years of experience required: 1 to 3 years experience Disqualifiers: None Additional qualities to look for: Flexibility to work a weekend rotation | ||||
| 1 | Clinical decision making | ||
| 2 | Ability to learn new skills quickly | |||
| 3 | Adaptability | |||
Position is offered by a no fee agency.
Location : Remote
Applicant Notices & Disclaimers
- For information on benefits, equal opportunity employment, and location-specific applicant notices, click here
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: $58.00/hr.