Pharmaceutical Clinical Services Specialist
1 day ago
About This Opportunity
As a Pharmaceutical Clinical Services Specialist at American Cybersystems, you will be responsible for evaluating prior authorization requests, appeals, and retrospective claim reviews to ensure accurate coverage recommendations. You will also provide guidance and support to medical directors, case managers, and other staff members on clinical, policy, and benefit-related questions and interventions.
Key Responsibilities
- Evaluate prior authorization requests, appeals, and retrospective claim reviews to ensure accurate coverage recommendations.
- Provide guidance and support to medical directors, case managers, and other staff members on clinical, policy, and benefit-related questions and interventions.
- Analyze healthcare cost information to identify trends and opportunities for quality improvement and cost-effective prescription drug programs.
Qualifications
- Bachelor's degree in Pharmacy or Doctor of Pharmacy (Ph.D.)
- 3-5 years of experience in clinical acute care/hospital setting
- Pharmacy license; successful completion of a pharmacy residency or advanced degree in health-related field is preferred
Salary Range: $112,000 - $184,000
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