Pharmacist Advisor

2 days ago

Washington, Washington, D.C., United States US Tech Solutions Full time
Job Title:

Pharmacist

Job Description:

We are seeking a highly skilled Pharmacist to join our team as an RPh Advisor. As an RPh Advisor, you will play a critical role in supporting Medicare Part D members and providers with requests related to their pharmacy benefits.

Your primary responsibility will be to ensure that cases are accurately set up for our members, review clinical information for decisioning the request, perform outreach to providers for more information when needed, and ensure accurate decisions that comply with compendia and Medicare guidance and timelines.

This is an excellent opportunity to initiate a career with a leading healthcare company by reviewing information and completing timely and accurate documentation of all Medicare Part D requests, in compliance with Medicare guidelines, while promoting a best-in-class service experience.

Responsibilities:
  1. Collaborate with multiple groups within CD&A, including answering clinical questions, collecting appropriate clinical/medical data needed to perform clinical assessments, and reviews as per the health plan/employer agreed criteria within the designated service level agreements.
  2. Coordinate timely communication of case decision to physician, health-plan/employer, patient and other healthcare professionals following agreed upon approval & denial management processes.
  3. Review cases in progress and provide a Clinical decision regarding Prior Authorizations, Tier Exceptions and Non-Formulary requests.
  4. Perform other related projects and duties as assigned, including on-call and after-hours pharmacist availability.
Requirements:
  • Pharmacist License of Current State
  • Prior Authorization Experience
  • Medicare Experience
  • Experience working in healthcare
About US Tech Solutions:

US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions.

To know more about US Tech Solutions, please visit our website.

US Tech Solutions is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

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