US Tech Solutions, Inc.
Pharmacist - RPh Operations Advisor - Specialty Medical Prior Authorization
US Tech Solutions, Inc., Atlanta, Georgia, United States
Duration: 6 months contract
Job Summary:
The clinical pharmacist is an operation-based role that conducts clinical reviews of medical data collected to perform prior authorization for specialty medications. The clinical pharmacist will apply clinical knowledge to plan approved criteria for prospective and concurrent reviews of cases. This role will work from client’s supported systems and take inbound calls from physician or members regarding their pending, approved, or denied prior authorizations.
Job Description:
Collaborating with Technicians and Nurses to process authorization requests, including answering clinical questions, collecting appropriate clinical/medical data needed to perform clinical assessments, and reviews as per the health plan/employer agreed criteria within the designated service level agreements. (20%) Coordinating timely communication of case decision to physician, health-plan/employer, patient and other healthcare professionals following agreed upon approval & denial management processes. (15%) Handling inbound phone calls and escalations from physicians or patients regarding Prior Authorization (50%) Establishing and maintaining communication among Clients, health plan and employer group staff. (5%) Maintaining professional and technical knowledge of drug and disease-states for the Specialty Medical programs administered within the Novologix platform. (5%) Performing other related projects and duties as assigned. On call and after-hours pharmacist availability may be required. (5%)
Experience:
2+ years of clinical experience with *specialty medications* or clinical review of prior authorization requests.
Skills:
Pharmacist Prior authorization Speciality medications
Education:
Bachelor's degree in pharmacy or Pharm D
About US Tech Solutions: US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions. To know more about US Tech Solutions, please visit
www.ustechsolutions.com
.
US Tech Solutions is an Equal Opportunity Employer.
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
Job Summary:
The clinical pharmacist is an operation-based role that conducts clinical reviews of medical data collected to perform prior authorization for specialty medications. The clinical pharmacist will apply clinical knowledge to plan approved criteria for prospective and concurrent reviews of cases. This role will work from client’s supported systems and take inbound calls from physician or members regarding their pending, approved, or denied prior authorizations.
Job Description:
Collaborating with Technicians and Nurses to process authorization requests, including answering clinical questions, collecting appropriate clinical/medical data needed to perform clinical assessments, and reviews as per the health plan/employer agreed criteria within the designated service level agreements. (20%) Coordinating timely communication of case decision to physician, health-plan/employer, patient and other healthcare professionals following agreed upon approval & denial management processes. (15%) Handling inbound phone calls and escalations from physicians or patients regarding Prior Authorization (50%) Establishing and maintaining communication among Clients, health plan and employer group staff. (5%) Maintaining professional and technical knowledge of drug and disease-states for the Specialty Medical programs administered within the Novologix platform. (5%) Performing other related projects and duties as assigned. On call and after-hours pharmacist availability may be required. (5%)
Experience:
2+ years of clinical experience with *specialty medications* or clinical review of prior authorization requests.
Skills:
Pharmacist Prior authorization Speciality medications
Education:
Bachelor's degree in pharmacy or Pharm D
About US Tech Solutions: US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions. To know more about US Tech Solutions, please visit
www.ustechsolutions.com
.
US Tech Solutions is an Equal Opportunity Employer.
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.