US Tech Solutions
Duration: 6+ months contract
Shift: Monday-Friday 9:30am-6pm local time zone or Sunday-Thursday 8am-4:30pm local time zone
Job Description: The clinical pharmacist is an operation based role that conducts clinical reviews of medical data collected to perform prior authorization for medications. The clinical pharmacist will apply clinical knowledge to plan approved criteria for prospective and concurrent reviews of cases. This position is responsible for reviewing and completing criteria based on prior authorization as per policy and procedure. This position is responsible for dispensing prescriptions and coordinating clinical services for specialty drugs serviced at the branch location. This position is responsible for interacting with the health care professionals in the provision and coordination of customer care. Must also translate prescriptions, perform compounds and dispense prescribed pharmaceuticals. Must be comfortable communicating by telephone or mail, with patients and physicians for patient care. Will also be responsible for resolving orders via the EA (External Adjudication) queue.
Responsibilities: This individual must have excellent interpersonal skills. Will be responsible for: Reviewing and completing criteria based on prior authorization as per policy and procedure. Answer phone lines promptly with priority on 'Pharmacist' line and escalated calls. Serves as the final decision-maker on all PA denials. Reviewing patient profile, drug interactions, sensitivities and drug usage database in relation to patient's prescription. Determines if prescription requires physician clarification or if it should be forwarded to therapeutic intervention or doctor phone calls for follow-up. Enters prescription in to the computer.
Experience: Position requires proficiency with computer skills which include multitasking, navigating multiple systems, and keyboarding. Experience using MS Office, other Windows based computer applications, web based processing and telephony programs. Minimum 2 years’ recent experience reviewing and processing prior authorizations against health plan criteria for a determination in a specialty/skilled clinical setting i.e., specialty medical office or Pharmacy Benefits Manager (PBM)
Skills: MUST HAVE MANAGED CARE exp and Medicare/Medicaid knowledge. MUST HAVE 6 months of experienced with Prior Authorization(required). Must Have Pharmacy Benefit Management (PBM) experience.
Education: Pharm D. required with at least two years experience as a pharmacist in Managed care environment. Must have an active license in the state of residence in good standing.
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.
Recruiter Details: Name: Sahil Email:
sahil.j@ustechsolutionsinc.com Internal Id:
25-49774
Shift: Monday-Friday 9:30am-6pm local time zone or Sunday-Thursday 8am-4:30pm local time zone
Job Description: The clinical pharmacist is an operation based role that conducts clinical reviews of medical data collected to perform prior authorization for medications. The clinical pharmacist will apply clinical knowledge to plan approved criteria for prospective and concurrent reviews of cases. This position is responsible for reviewing and completing criteria based on prior authorization as per policy and procedure. This position is responsible for dispensing prescriptions and coordinating clinical services for specialty drugs serviced at the branch location. This position is responsible for interacting with the health care professionals in the provision and coordination of customer care. Must also translate prescriptions, perform compounds and dispense prescribed pharmaceuticals. Must be comfortable communicating by telephone or mail, with patients and physicians for patient care. Will also be responsible for resolving orders via the EA (External Adjudication) queue.
Responsibilities: This individual must have excellent interpersonal skills. Will be responsible for: Reviewing and completing criteria based on prior authorization as per policy and procedure. Answer phone lines promptly with priority on 'Pharmacist' line and escalated calls. Serves as the final decision-maker on all PA denials. Reviewing patient profile, drug interactions, sensitivities and drug usage database in relation to patient's prescription. Determines if prescription requires physician clarification or if it should be forwarded to therapeutic intervention or doctor phone calls for follow-up. Enters prescription in to the computer.
Experience: Position requires proficiency with computer skills which include multitasking, navigating multiple systems, and keyboarding. Experience using MS Office, other Windows based computer applications, web based processing and telephony programs. Minimum 2 years’ recent experience reviewing and processing prior authorizations against health plan criteria for a determination in a specialty/skilled clinical setting i.e., specialty medical office or Pharmacy Benefits Manager (PBM)
Skills: MUST HAVE MANAGED CARE exp and Medicare/Medicaid knowledge. MUST HAVE 6 months of experienced with Prior Authorization(required). Must Have Pharmacy Benefit Management (PBM) experience.
Education: Pharm D. required with at least two years experience as a pharmacist in Managed care environment. Must have an active license in the state of residence in good standing.
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.
Recruiter Details: Name: Sahil Email:
sahil.j@ustechsolutionsinc.com Internal Id:
25-49774