Pharmacist I

3 weeks ago


Raleigh, United States Integrated Resources Full time
Duties:
  • s a licensed health care professional employed in the Pharmacy Prior Authorization Department your primary responsibility is to make determinations on prior authorization and coverage requests for pharmaceutical products.
  • Determinations include medical necessity and benefit decisions. Decisions are made in accordance with established pharmacy guidelines, contract criteria, industry regulations and sound clinical judgment.
  • The Prior Authorization pharmacist works independently with respect to reviews and decision making, with the support of senior pharmacist staff and supervisors. You will work as member of a team of peers committed to meeting or exceeding quality standards and customer performance guarantees.

dditional responsibilities include:
  • Telephonically provide clinical support to the PerformRx Contact Center
  • Engage providers in discussions to support determinations
  • Support Fraud and Abuse program system oversight.
  • Participate in various Pharmacy-related projects
  • Keep abreast of industry trends and regulatory changes
  • Keep abreast of operational directives and customer reference materials

Education:
  • Current pharmacy license in North Carolina REQUIRED
  • Must Reside in North Carolina

Languages:
English( Speak, Read, Write )

Skills:
  • 2 years pharmacy experience preferred
  • Previous experience in managed care environment preferred

City: Raleigh

Schedule:
Start Date: 06/17/2024
End Date: 10/15/2024
Schedule Notes: Monday- Friday 8:30am-5pm EST
Hours Per Week: 40.00
Hours Per Day: 8.00
Days Per Week: 5.00
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