Position Title: Clinical Pharmacist 1
Work Location: Remote (Preferred NC, AZ, KS, TX, IN, GA, NJ, CA, FL)
Assignment Duration: 6 months possible extension (temp to permanent)
Work Schedule: 8 hour shift (typically 9-530pm in worker’s timezone)

Position Summary:

• Purpose: Primary duty for this position is to review prior authorization requests for medical benefit (buy and bill) drugs requests across the Medicare, Medicaid, Exchange, and Commercial lines of business
• This position is fully remote. We prefer a candidate with strong clinical skills, drug knowledge, and managed care experience in prior authorization review. We expect a candidate that embodies Centene culture.

• : Setting clear goals, being transparent about outcomes, and inviting feedback to foster growth. 
• : Pushing past fear and uncertainty to make the best possible decisions.
• : Approaching every interaction as an opportunity to learn.
• : Demonstrating integrity, honesty, and vulnerability to build strong relationships.
• : Focusing our work through the lens of our mission.•Our department receives and reviews prior authorization requests for medical benefit (buy and bill) drugs requests across the Medicare, Medicaid, Exchange, and Commercial lines of business

•They will be required to review the doctor’s request based on defined criteria to determine if the medication can be approved or denied.
•The RFS production goal is 90%. This goal should be met daily and monthly. This goal roughly averages to 47 cases completed per day.
The quality goal is 99.9%.

Years of experience required: 1+ years of retail, hospital, managed care, or PBM experience. Previous experience with reviewing prior authorizations for a managed care organization/PBM.

 

Candidate Requirements
Required: Bachelor’s or Doctorate of Pharmacy degree.	Preferred:
Required: Current state’s Pharmacist license with no restrictions.	Preferred: Pharmacist Licenses we required based on business needs: NC AZ KS TX              IN              GA NJ CA FL

 
 
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 pay range is $58.00/hr - $62.00/hr.