Description: Our client is currently seeking Clinical Pharmacists/Prior Authorization!
Onsite in Irvine, CA Contract (Until 5/31/24)
Training is 8am-5pm. Monday- Friday. After training, schedule can range between 9am-9pm, 5 days a week.
Overview: This position is for a Clinical Pharmacist working in the Prior Authorization unit.. This is a call center based business segment. The pharmacist's primary role is reviewing Prior Authorization cases and rendering coverage determinations based on clinical criteria and plan design in a fast paced and dynamic environment.
Responsibilities:
Work is computer based and include receiving phone calls from prior authorization pharmacy technicians and/or providers for clinical information
Consult with pharmacy technicians and/or physicians regarding use of medications and advise of appropriate formulary alternatives when requested.
Perform all duties and functions in compliance with state and federal pharmacy laws and regulations
Dedication to build rapport with coworkers, internal customers, and other departments by demonstrating a strong customer service orientation and a continuous positive image of .
Conform with and supports department quality assurance and improvement guidelines
Organize workload, sets priorities, completes assignments in a timely manner and utilizes resources appropriately while complying with department program standards
Gather complex clinical information, coverage policy and criteria information and work within regulatory guidelines to make coverage determinations
Consult physicians/providers with questions, interpret clinical guideline criteria, and render/review coverage determination for prior authorization cases
Qualifications & Requirements:
High School/GED, Associates degree or 3-5 years of equivalent work experience
1 - 3 years of previous experience as a Pharmacist is preferred
1 year of customer service experience analyzing and solving customer problems, OR 1 year of experience in an office setting environment using the phone and computer.
1 to 3 years of PC skills (MS Word, Excel) proficiency is preferred
Warm Regards,
Contact: vsantis@judge.com
This job and many more are available through The Judge Group. Find us on the web at www.judge.com
