Clinical Solution Provider

2 days ago


Chattanooga, Tennessee, United States Global Channel Management Full time

We are seeking a Clinical Solution Provider to join our team at Global Channel Management. As a key member of our pharmacy operations team, you will be responsible for designing and implementing clinical solutions that meet business objectives.

Job Description
  • Develop and maintain clinical decision trees in the prior authorization system
  • Respond to prescriber, pharmacy provider, member appeals, grievances and complaints related to the provision of pharmaceutical services within established time periods

The ideal candidate must have a strong understanding of regulatory guidelines (FDA, NCQA, EQRO, CMS) and be able to work effectively in a team environment.

Requirements
  • A Doctor of Pharmacy (PhD) Degree
  • 3 years - Clinical experience required
  • Preferrable: Coverage review experience
  • Comptency in compendia navigation and research
  • Proficient in Microsoft Office (Outlook, Word, Excel and PowerPoint)

The estimated salary for this position is $120,000 - $150,000 per year.



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