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Keywords: pharmacist, North Carolina, NCPDP, prior authorization, prior authorization, review, utilization review, pharmacy, non-formulary drugs, NDC, GCN, GPI, USC, compliance, remote, PharmD, RPh, NC, Raleigh, Charlotte, Fayetteville, Greensboro, RTP.
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Remote Prior Authorization Pharmacist. We are actively seeking a dedicated Pharmacist to join our remote team with a focus on Prior Authorization. PharmD degree from an accredited pharmacy program - Prior experience in Prior Authorization - State pharmacy license in good standing (remote work eligibility) - Clinical pharmacy experience with a focus on therapeutic knowledge - Strong analytical and decision-making skills - Excellent communication and collaboration abilities for remote interactions - Familiarity with healthcare regulations and compliance standards - Dedication to staying informed about industry trends and innovations.
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Verify eligibility and benefits for the medication requested as well as follow-up submitted prior authorization/pre-certification requests with the health plan ensuring timely turn-around time.
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Participates in assisting patients and Pharmacist with prior authorization procurement for patients at Bryan Medical Center, Bryan Health entities or Bryan Employee Specialty Pharmacy.
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Provides clinical, pharmacy, and medication expertise in each area including policy development, pharmacy operations, prior authorization support and medication therapy outcomes. JOB DESCRIPTION :The OP Ambulatory Pharmacist Clinician is an advanced practice pharmacist responsible for assuring optimal drug use outcomes in high risk, high cost or complex patient populations.
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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.
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Develop and master an understanding of product and payer reimbursement landscape and prior authorization guidelines and processes. Collects and communicate all data needed to facilitate prior authorization approvals.
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The incumbent may write drug monographs for Committee review; develops and implements the Organization's management programs including but not limited to: prior authorization, dose and duration edits, quantity limits, step-care edits, generic sampling, pharmacy policy review and development and/or review of member specific information to improve individual outcomes as an adjunct to health coaching.
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Evaluates medication utilization and prior authorization requests for medications available via the pharmacy benefit and the medical benefit including specialty ambulatory injectable and/or infusion medications as related to member benefits, medical necessity, site of service, and evidence based clinical guidelines.
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In this role, you will play a crucial part in evaluating medication requests, ensuring adherence to guidelines, and facilitating the prior authorization process—all from the convenience of your remote work environment.
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Apply now to play a vital role in streamlining the prior authorization process and enhancing patient care remotely. Apply now to play a vital role in streamlining the prior authorization process and enhancing patient care remotely.
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The ideal candidate will bring strong clinical knowledge, excellent communication skills for remote collaboration, and a commitment to optimizing medication access for patients.
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The ideal candidate will bring strong clinical knowledge, excellent communication skills for remote collaboration, and a commitment to optimizing medication access for patients.
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Job Description Location: UC Health, Business Center Department: Pharmacy Administration Hours: Full-Time, 40 hours/weekly Shift: First Shift UC Health is hiring a full-time Certified Pharmacy Technician for Prior Authorization, Medication Access Services in Pharmacy Administration at University of Cincinnati's Medical Center.
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The pharmacist will be responsible for overseeing the prior authorization and appeals processes and offering clinical assistance to technician staff completing the authorizations as needed.
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