A company is looking for a Clinical Pharmacist, Utilization Management (Part B Drugs).
Key Responsibilities
Review prior authorization requests for drugs and biologics under Part B benefits
Evaluate appeals of previously denied requests and ensure member understanding of benefits
Support internal clinical and non-clinical staff in understanding policies and procedures
Required Qualifications
Doctorate of Pharmacy degree (PharmD)
Active pharmacist license in at least one state
Minimum of 2 years of utilization management experience or completion of a managed care residency
Willingness to work Monday-Friday 8am to 5pm EST with rotating weekend on-call
Experience with pharmacy-related quality assurance work is preferred
Clinical Pharmacist • Torrance, California, United States