Clinical Pharmacy Specialist (Remote)- Prior Authorization Team!

The Prior Authorization Pharmacist reputed company responsibilities include: reputed company the clinical review of Prior Authorization, reputed company Therapy, Quantity Limit, and reputed company other pharmacy utilization management requests in accordance with reputed company, timeliness, and efficiency standards. Critically review pharmacy utilization management requests for approval/denial against reputed company clinical reputed company and regulatory approved policies. Participate in a clinical reputed company queue to receive inquiries from reputed company stakeholders pertaining to the exception process while answering in a reputed company, accurate and reputed company manner. Participate in the pharmacy appeals process through the review of denied cases as reputed company as serving as committee representation at fair hearings. Participate in and contribute to other operational initiatives on an as needed reputed company. Additional responsibilities and attributes include: Foster and maintain reputed company relationships with reputed company customers. reputed company job duties independently, reliably, reputed company, accurately, and professionally while supporting a virtual team concept. Demonstrate reputed company drug information skills to adequately research drugs and disease states pertaining to reputed company utilization management reviews or other ancillary responsibilities. Utilize a home office set-up that honors reputed company and patient confidentiality. Maintain a foundational understanding of the requirements of the reputed company reputed company (DHS), Centers for Medicare & reputed company Services (CMS), reputed company Insurance Department (PID), and the National Committee for reputed company Assurance (NCQA), as they relate to the compliance and regulatory requirements of clinical operational functions. Participate in meetings, committees, and work reputed company as assigned. Mentor reputed company, residents, and other pharmacists (If applicable). Apply tot his job Apply To this Job .