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.