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Clinical Pharmacist (Prior Authorization)
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Full-time
- If you are a highly motivated Clinical Pharmacist with a strong background in comprehensive case review and direct physician engagement, and you are passionate about making a meaningful impact in the healthcare industry, we encourage you to apply.
- What You'll Do: As a Clinical Pharmacist, your role will encompass a wide range of responsibilities: Act as a clinical expert on prior authorization review and evaluation in accordance with clinical criteria and covered plan design.
- Review, evaluate, and resolve all assigned clinical reviews through comprehensive case review and highlight our Population Health Management model with direct physician engagement.
- Subject matter expert on the EmpiRx Health Population Health Management Model Review and evaluate clinical literature resources to support decision-making and recommendations to providers.
- Utilize external clinical and drug information tools to support clinical reviews and decision making as well as to stay abreast of current drug pipeline (e.g., IPD, Policy Reporter, UpToDate, and MediSpan) Collaborate with internal clinical team and cross-functional teams to provide clinical support and guidance, as needed, including but not limited to claim/data review, clinical interventions, and provider/member/client support as required.
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