Prior Authorization Clinical Pharmacist

3 weeks ago


Lakeland, United States WELLDYNE Full time
Job DescriptionJob Description

Summary

Under the direction of the Manager, Clinical Services, practice in accordance with local, state, and federal rules and regulations. Handle the clinical review process for Prior Authorizations as it pertains to retail clients of WellDyne.

Essential Duties and Responsibilities

  • Accountable for decision-making for clinical pharmacy reviews, questions from Account Teams and PA support staff, as well as maintaining a comprehensive library of clinical forms for use by the team.
  • Responsible for participating in formulary development, pharmacy service related processes, and clinical programs in accordance with company policy and to promote a positive customer experience.
  • Responsible for practicing in accordance with local, state, and federal rule and regulations.
  • Contribute to and support an atmosphere of effective teamwork.
  • Attend pertinent meetings when necessary.
  • Assist in training and developing other pharmacy personnel.
  • Follow and aid in enforcement of all company policies and procedures.
  • Responsible for keeping abreast of developments in the professional field.
  • Respect and maintain confidentiality guidelines of HIPAA.
  • Answer clinical drug information questions as requested.

Education and Experience

  • A valid Pharmacist License, in good standing.
  • Ability to become licensed in multiple states as required.
  • Two years minimum of pharmacy experience
  • Familiarity with Microsoft Word, Excel, and Outlook
  • Drug Information background preferred
Knowledge, Skills, and Abilities
  • Attention to detail.
  • Ability to communicate effectively, patiently, and courteously.
  • Ability to handle multiple activities or interruptions at once.
  • Focused team player, who can work in conjunction with pharmacists, other departments, customers, and management.
  • Work independently and make clinical decisions with little supervision and meet daily deadlines.

Work Environment / Physical Demands

This position is in a typical office environment which requires prolonged sitting in front of a computer. Requires hand-eye coordination and manual dexterity sufficient to operate standard office equipment including operation of standard computer and phone equipment. May have occasional high stress when dealing with customers/clients. Some travel may be required.

EOE M/F/D/V



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