RemoteWorker US hiring Remote PBM Prior Authorization Pharmacist in Woonsocket, Rhode Island, United States | LinkedIn
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Collaborates with multiple groups within CD&A, 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%)
Coordinates timely communication of case decision to physician, health-plan/employer, patient and other healthcare professionals following agreed upon approval & denial management processes. (20%)
Reviews cases in progress and provides a Clinical decision regarding Prior Authorizations, Tier Exceptions and Non-Formulary requests (50%)
Performs other related projects and duties as assigned including on call and after hours pharmacist availability could be required. (10%)
Benefits are available to full-time employees after 90 days of employment and include health, optical, dental, life, and short-term disability insurance.
A 401(k) with a company match is available for full-time employees with 1 year of service on our eligibility dates.
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