Pharmacy Specialist
4 weeks ago
Job Summary:
This position is responsible for receiving verbal and written requests for prior authorization from pharmacists, physicians and/or patients and is responsible for supporting and assisting in the coordination of Pharmacy Services activities including claim utilization analysis, prescription plan design, ad-hoc reporting, correspondence and special projects. Must maintain performance in compliance with organizational or department goals and in compliance with regulatory agencies
Responsibilities:
Process prior authorizations received via prior authorization help line, by evaluating the medical necessity/appropriateness for specific drugs and based on medical criteria.
- Directly interact with members physician office staff, pharmacies and internal stake holders for eligibility, coverage determination claims issues.
- Conduct intervention with physician & pharmacy office staff to facilitate formulary compliance and generic dispensing.
- Process appeals complaints executive inquiries and compliance related issues.
- Provide recommendations to increase efficiency, accuracy and productivity in the department.
- Process ad hoc request for information or reports from stakeholders.
- Participate in client member and employee training to ensure practical understanding of pharmacy services programs and operations.
- Assist in the day to day business functions of the pharmacy department as well as the Medication Therapy Management program.
- Provide support to various clinical programs within the pharmacy department.
Education/Experience:
- Prefers a Bachelor's degree from an accredited college or university in Health Care Management, Business or Pharmaceutical Administration.
- Requires minimum of two (2) years experience in third party prescription program claim adjudication.
- Requires minimum of two (2) years experience as a Pharmacy Utilization Management Specialist.
- Requires prior customer service/service quality initiative experience.
-
Pharmacy Specialist Level 1
4 weeks ago
Newark, United States Integrated Resources Full timeJob Summary: This position is responsible for receiving verbal and written requests for prior authorization from pharmacists, physicians and/or patients and is responsible for supporting and assisting in the coordination of Pharmacy Services activities including claim utilization analysis, prescription plan design, ad-hoc reporting, correspondence and...
-
Pharmacy Specialist Level 1
4 weeks ago
Newark, United States Talent Software Services Full timePosition Summary: This position is responsible for receiving verbal and written requests for prior authorization from pharmacists, physicians and/or patients and is responsible for supporting and assisting in the coordination of Pharmacy Services activities including claim utilization analysis, prescription plan design, ad-hoc reporting, correspondence and...
-
Newark, United States ChristianaCare Full timeDo you want to work at one of the top 100 hospitals in the nation?ChristianaCare is currently recruiting for a Oncology/Hematology Clinical Pharmacy Specialist to join our team.Life is full of choices, and ChristianaCare recognizes whom you work for is an important decision. Choose an organization that values pharmacy services and provides the opportunity to...
-
Newark, United States ChristianaCare Full timeDo you want to work at one of the top 100 hospitals in the nation?ChristianaCare is currently recruiting for a Oncology/Hematology Clinical Pharmacy Specialist to join our team.Life is full of choices, and ChristianaCare recognizes whom you work for is an important decision. Choose an organization that values pharmacy services and provides the opportunity to...
-
Newark, United States ChristianaCare Full timeDo you want to work at one of the top 100 hospitals in the nation?ChristianaCare is currently recruiting for a Oncology/Hematology Clinical Pharmacy Specialist to join our team.Life is full of choices, and ChristianaCare recognizes whom you work for is an important decision. Choose an organization that values pharmacy services and provides the opportunity to...
-
Newark, United States Christiana Care Health System Full timeJob Details Do you want to work at one of the top 100 hospitals in the nation? ChristianaCare is currently recruiting for a Oncology/Hematology Clinical Pharmacy Specialist to join our team. Life is full of choices, and ChristianaCare recognizes whom you work for is an important decision. Choose an organization that values pharmacy services and provides...
-
Newark, United States Christiana Care Health System Full timeJob Details Do you want to work at one of the top 100 hospitals in the nation? ChristianaCare is currently recruiting for a Oncology/Hematology Clinical Pharmacy Specialist to join our team. Life is full of choices, and ChristianaCare recognizes whom you work for is an important decision. Choose an organization that values pharmacy services and provides...
-
Newark, United States ChristianaCare Full timeDo you want to work at one of the top 100 hospitals in the nation?ChristianaCare is currently recruiting for a Oncology/Hematology Clinical Pharmacy Specialist to join our team.Life is full of choices, and ChristianaCare recognizes whom you work for is an important decision. Choose an organization that values pharmacy services and provides the opportunity to...
-
Newark, United States ChristianaCare Full timeDo you want to work at one of the top 100 hospitals in the nation?ChristianaCare is currently recruiting for a Oncology/Hematology Clinical Pharmacy Specialist to join our team.Life is full of choices, and ChristianaCare recognizes whom you work for is an important decision. Choose an organization that values pharmacy services and provides the opportunity to...
-
Newark, United States ChristianaCare Full timeDo you want to work at one of the top 100 hospitals in the nation?ChristianaCare is currently recruiting for a Oncology/Hematology Clinical Pharmacy Specialist to join our team.Life is full of choices, and ChristianaCare recognizes whom you work for is an important decision. Choose an organization that values pharmacy services and provides the opportunity to...
-
Newark, United States ChristianaCare Full timeDo you want to work at one of the top 100 hospitals in the nation?ChristianaCare is currently recruiting for a Oncology/Hematology Clinical Pharmacy Specialist to join our team.Life is full of choices, and ChristianaCare recognizes whom you work for is an important decision. Choose an organization that values pharmacy services and provides the opportunity to...
-
Pediatrics Clinical Pharmacy Specialist
6 days ago
Newark, New Jersey, United States Newark Beth Israel Medical Center Full timeJob Title: Clinical PharmacistLocation: Newark Beth Israel Medical Center Req#: Status: Full-Time Shift: Day Department name: Cardia Catheter LabJob Overview:The Children s Hospital of New Jersey provides comprehensive inpatient and outpatient pediatric services that include a pediatric intensive care unit, pediatric emergency department, Valerie Fund...
-
Newark, United States ChristianaCare Full timeJob DetailsDo you want to work at one of the top 100 hospitals in the nation?ChristianaCare is currently recruiting for a Oncology/Hematology Clinical Pharmacy Specialist to join our team.Life is full of choices, and ChristianaCare recognizes whom you work for is an important decision. Choose an organization that values pharmacy services and provides the...
-
Newark, United States ChristianaCare Full timeJob DetailsDo you want to work at one of the top 100 hospitals in the nation?ChristianaCare is currently recruiting for a Oncology/Hematology Clinical Pharmacy Specialist to join our team.Life is full of choices, and ChristianaCare recognizes whom you work for is an important decision. Choose an organization that values pharmacy services and provides the...
-
Pediatrics Clinical Pharmacy Specialist
3 weeks ago
Newark, NJ, United States Newark Beth Israel Medical Center Full timeLocation: Newark Beth Israel Medical Center Status: Full-Time Shift: Day Cardia Catheter Lab The Children s Hospital of New Jersey provides comprehensive inpatient and outpatient pediatric services that include a pediatric intensive care unit, pediatric emergency department, Valerie Fund Children s Center for Cancer and Blood Disorders, and a...
-
Pediatrics Clinical Pharmacy Specialist
4 weeks ago
Newark, NJ, United States Newark Beth Israel Medical Center Full timeLocation: Newark Beth Israel Medical Center Status: Full-Time Shift: Day Cardia Catheter Lab The Children s Hospital of New Jersey provides comprehensive inpatient and outpatient pediatric services that include a pediatric intensive care unit, pediatric emergency department, Valerie Fund Children s Center for Cancer and Blood Disorders, and a...
-
Pediatrics Clinical Pharmacy Specialist
6 days ago
Newark, NJ, United States Newark Beth Israel Medical Center Full timeLocation: Newark Beth Israel Medical Center Status: Full-Time Shift: Day Cardia Catheter LabThe Children’s Hospital of New Jersey offers comprehensive pediatric services, including a pediatric intensive care unit, emergency department, Valerie Fund Children’s Center for Cancer and Blood Disorders, and New Jersey's only ECMO unit. The pediatric clinical...
-
Newark, DE, United States ChristianaCare Full timeDo you want to work at one of the top 100 hospitals in the nation?ChristianaCare is currently recruiting for a Oncology/Hematology Clinical Pharmacy Specialist to join our team.Life is full of choices, and ChristianaCare recognizes whom you work for is an important decision. Choose an organization that values pharmacy services and provides the opportunity to...
-
Newark, DE, United States ChristianaCare Full timeDo you want to work at one of the top 100 hospitals in the nation?ChristianaCare is currently recruiting for a Oncology/Hematology Clinical Pharmacy Specialist to join our team.Life is full of choices, and ChristianaCare recognizes whom you work for is an important decision. Choose an organization that values pharmacy services and provides the opportunity to...
-
Newark, DE, United States ChristianaCare Full timeDo you want to work at one of the top 100 hospitals in the nation?ChristianaCare is currently recruiting for a Oncology/Hematology Clinical Pharmacy Specialist to join our team.Life is full of choices, and ChristianaCare recognizes whom you work for is an important decision. Choose an organization that values pharmacy services and provides the opportunity to...
