Medical Coverage Manager
4 weeks ago
Global Channel Management is committed to delivering high-quality pharmaceutical services to our clients. We are currently seeking a skilled Medical Coverage Manager to join our team.
We offer a competitive salary of $125,000 per year, plus benefits and opportunities for professional growth.
Job Description
The successful candidate will be responsible for navigating compendia, researching medical and pharmacy products, and maintaining regulatory compliance. They will also be required to perform prospective and retrospective coverage reviews and appeals, respond to prescriber, pharmacy provider, member appeals, grievances and complaints related to the provision of pharmaceutical services, build and maintain decision trees in the prior authorization system, and maintain denial rationale associated with clinical criteria.
Required Skills and Qualifications
The ideal candidate will have a Doctor of Pharmacy (PharmD) degree, 8 years of strong experience in technical design, development, implementation, and support of enterprise solutions, and proficiency in Microsoft Office. Strong interpersonal and organizational skills, as well as excellent oral and communication skills, are essential for this role.
Benefits
As a valued member of our team, you will enjoy a comprehensive benefits package, including medical, dental, and vision coverage, retirement savings plan, and paid time off.
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