Clinical Pharmacist

2 days ago

Salem, Oregon, United States Russell Tobin Full time
Job Title: Clinical Pharmacist - Prior Authorization Specialist

Job Summary:

Russell Tobin is seeking a highly skilled Clinical Pharmacist to join our team as a Prior Authorization Specialist. In this role, you will be responsible for reviewing prior authorization cases and rendering coverage determinations based on clinical criteria and plan design.

Key Responsibilities:

  • Review prior authorization cases and render coverage determinations based on clinical criteria and plan design
  • Consult with 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
  • Have sharp attention to detail, using established criteria and guidelines, gather complex clinical information, coverage policy and criteria information, and work within regulatory guidelines to make coverage determinations
  • Organize workload, set priorities, complete assignments in a timely manner, and utilize resources appropriately while complying with department program standards
  • Perform all duties and functions in compliance with state and federal pharmacy laws and regulations
  • Conform with and support department quality assurance and improvement guidelines
  • Demonstrate ability to maintain productive working relationships with team members, other internal and external customers, and management team
  • Patient safety and quality of work is paramount, and it's essential for employees to have a safe and secure workspace and communicate with their leadership when that safety (equipment, system, information) is compromised
  • Resolve issues and complaints in a timely manner
  • Perform other duties as assigned by management

Requirements:

  • Bachelor's or Doctorate of Pharmacy; Active State Pharmacist License
  • 6+ months of Customer Service/Customer Relations with Healthcare professionals
  • Basic proficiency with Microsoft Excel (ability to create, edit, and save a basic spreadsheet), Microsoft Word (ability to create, edit, and save a basic document), and Microsoft Outlook (ability to send emails)

Benefits:

Russell Tobin offers eligible employees comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance, and hospital indemnity), a 401(k)-retirement savings, life & disability insurance, an employee assistance program, identity theft protection, legal support, auto and home insurance, pet insurance, and employee discounts with some preferred vendors.

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