Clinical Pharmacist Advisor

5 days ago


Ohio City, Ohio, United States Umanist Staffing LLC Full time
Job Overview

This is a remote opportunity for a Clinical Pharmacist Advisor to join our team at Umanist Staffing LLC. As a Clinical Pharmacist Advisor, you will play a crucial role in supporting Medicare Part D members and providers with requests related to their pharmacy benefits.

Key Responsibilities
  • Ensure accuracy of case setup and clinical review of Medicare appeals cases
  • Review internal notes or fax requests thoroughly for pertinent information
  • Provide clear, concise, and accurate documentation for case reviews
  • Contact providers, if needed, for clinical information to decision cases
  • Utilize work instructions and Medicare guidelines for accurate case processing
Requirements
  • Active pharmacist license in the state of residence that is in good standing
  • Ability to utilize multiple software systems, simultaneously with a 2-screen workstation setup (Windows based operations, AS400, MHK, PeopleSafe, WI database, Microsoft office applications)
  • Ability to type 30 WPM or greater
  • Ability to utilize compendia (Micromedex, Lexicomp, etc) to evaluate and support case decisions
  • Excellent oral and written communication skills
  • Ability to multitask, prioritize, and manage time effectively in a fast-paced, highly regulated environment
  • Must be able to review large volume of information, determine importance, and apply clinical knowledge to assist in outcome
  • Demonstrated ability to work independently and utilize critical thinking/problem solving skills to make case decisions
  • Receptive to constructive feedback and flexible in adapting to change
  • Flexibility with working a rotating schedule including overtime, weekends, and holidays
Work Environment

This is a work-from-home position, and you must have a dedicated quiet, separate space in which to work with wired internet meeting 25mbps min download and 5mbps minimum upload speed. Previous WFH experience is preferred.

What We Offer

As a Clinical Pharmacist Advisor at Umanist Staffing LLC, you will have the opportunity to work with a leading healthcare company, promoting a best-in-class service experience. You will be responsible for ensuring cases are accurately set up for our members, reviewing clinical information for decisioning the request, performing outreach to providers for more information when needed, and ensuring accurate decisions that comply with compendia and Medicare guidance and timelines.

This is a great 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.



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