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hc - pharmacist - intermediate

2 months ago

Philadelphia, Pennsylvania, United States The Judge Group Inc. Full time
Location: Philadelphia, PA
Description: Our client is currently seeking a HC - PHARMACIST - INTERMEDIATE

This job will have the following responsibilities:
  • This position is for a Clinical Pharmacist.
  • This is a call center based business segment and strict work guidelines are employed.
  • Primary role is reviewing Prior Authorization cases and rendering coverage determinations based on clinical criteria and plan design in a fast paced and dynamic environment.
  • Primary Responsibilities: Work is computer based and include receiving phone calls from prior authorization pharmacy technicians and/or providers for clinical information
  • Consult physicians/providers with questions, interpret clinical guideline criteria, and render/review coverage determination for prior authorization cases
  • Consult with pharmacy technicians and/or physicians regarding use of medications and advise of appropriate formulary alternatives when requested.
  • Gather complex clinical information, coverage policy and criteria information and work within regulatory guidelines to make coverage determinations
  • Organize workload, sets priorities, completes assignments in a timely manner and utilizes resources appropriately while complying with department program standards
  • Dedication to build rapport with coworkers, internal customers, and other departments by demonstrating a strong customer service orientation and a continuous positive image.
  • Demonstrate ability to maintain productive working relationships with team members, other internal and external customers, and management team. *
Qualifications & Requirements:
  • Training is for 4 weeks. Training time is 8:00am-5:00pm. Monday- Friday.
  • Candidate must be available as early as 5am and as late as midnight.
  • Candidate will work 5 days a week which may or may not include a weekend day(s).
  • There is scheduled Overtime and working on Holidays.
  • Candidate must have their own home internet access/VPN (internet can be hard wired with Ethernet cord)
  • Candidate must also have a secure work space/office in their home
  • Candidate must have level skill with working with PC
  • Excellent Attendance is a must active state Pharmacist license.
Contact:

This job and many more are available through The Judge Group. Find us on the web at