Licensed Pharmacist
Location: REMOTE Salary: $45.00 USD Hourly - $60.00 USD Hourly Description: Our client is currently seeking a Licensed Pharmacist Description: Regulatory requirements to utilize a US based and US licensed resource to conduct UM reviews.
US licensed Pharmacist with minimum of 3-5 years health plan experience and the Utilization Management/Prior Authorization experience required to be able to conduct clinical reviews of medical benefit and pharmacy drug reviews and issue either an approval or a recommendation to deny with supporting rationale for final decision by the health plan's MD.
Provide clinical review and support of payer's pharmacy clinical policies.
Required skills: 1) Minimum of 3-5 years health insurance plan experience 2) Minimum of 3-5 years conducting utilization management reviews for medical and pharmacy prior authorization requests 3) Experience with reviewing and providing input into clinical pharmacy policies that define criteria required to support payer coverage decisions 4) Minimum of 5 years’ experience with Microsoft applications (Word, powerpoint, excel, etc.) Desired Skills: 1) Ability to work independently 2) Experience working in electronic medical records (EMR) systems By providing your phone number, you consent to: (1) receive automated text messages and calls from the Judge Group, Inc.
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