Clinical Pharmacist

Title : Clinical Pharmacist

Location : Remote (must reside in one of the following states : Nevada, Arizona, New Mexico, Utah, Montana, Idaho, Oregon and Colorado)

Job Type : Contract-To-Hire

Start Date : 9 / 23 or 9 / 30 or 10 / 14

End Date : 5 / 31

Hours : Training 8 : 30am-5 : 30pm PST (5 weeks), Post Training 10 : 30am-7pm PST

Pay Rate : $59.38 - $63.70 per hour

The essential functions of a Pharmacists in Prior Authorization are reviewing Prior Authorization cases and rendering coverage determinations based on clinical criteria and plan design in a fast paced and dynamic environment.

Prior Authorization staff pharmacists review all adverse coverage determinations before final decisions are rendered and as required by law work in conjunction with medical directors to render final decisions on coverage determinations.

This is a dynamic work environment and requires flexibility to meet business needs and adaptability to frequent changes.

Teamwork is the norm and all employees will be held accountable to work as effective team members.

This position is for a Clinical Pharmacist working in the Prior Authorization unit within Customer Service department. This is a call center based business segment and strict work guidelines are employed.

The pharmacist’s primary role is reviewing Prior Authorization cases and rendering coverage determinations based on clinical criteria and plan design in a fast paced and dynamic environment.

Primary Responsibilities :

• Work is computer based and include receiving phone calls from prior authorization pharmacy technicians and / or providers for clinical information
• Consult physicians / providers with questions, interpret clinical guideline criteria, and render / review coverage determination for prior authorization cases
• Consult with pharmacy technicians and / or physicians regarding use of medications and advise of appropriate formulary alternatives when requested.
• Have sharp attention to detail, Using established criteria and guidelines, Gather complex clinical information, coverage policy and criteria information and work within regulatory guidelines to make coverage determinations
• Organize workload, sets priorities, completes assignments in a timely manner and utilizes resources appropriately while complying with department program standards
• Perform all duties and functions in compliance with state and federal pharmacy laws and regulations
• Conform with and supports department quality assurance and improvement guidelines
• Dedication to build rapport with coworkers, internal customers, and other departments by demonstrating a strong customer service orientation and a continuous positive image of Client
• Demonstrate ability to maintain productive working relationships with team members, other internal and external customers, and management team.
• Patient Safety and Quality of work is paramount and it’s important for employees to have a safe and secure workspace and communicate with their leadership when that safety (equipment, system, information) is compromised
• Resolve issues and complaints in a timely manner
• Performs other duties as assigned by management
• Training is for 5 weeks. Training time is 8 : 00am-5 : 00pm local time. Monday- Friday. This training time is subject to change
• Shift after training is an 8-hour shift with an hour lunch.
• Candidate will work 5 days a week which may or may not include a weekend day(s)
• There may be scheduled overtime and / or working on holidays dependent on business needs
• Candidate must have their own home internet access (internet can be hard wired with Ethernet cord)
• Candidate must also have a secure workspace / office in their home
• Candidate must have level skill with working with PC (ex. using mouse and keyboard, accessing and navigating through multiple systems and screens)
• Excellent attendance is a must

Required Qualifications :

• Bachelors or Doctorate of Pharmacy; Active State Pharmacist License
• 6 + months of Customer Service / Customer Relations with Healthcare professionals
• Basic proficiency with Microsoft Excel (ability to create, edit, and save a basic spreadsheet), Microsoft Word (ability to create, edit, and save a basic document), and Microsoft Outlook (ability to send emails)

Benefits that Russell Tobin offers :

Russell Tobin offers eligible employee’s comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance and hospital indemnity), a 401(k)-retirement savings, life & disability insurance, an employee assistance program, identity theft protection, legal support, auto and home insurance, pet insurance, and employee discounts with some preferred vendors.

Apply Today!

If you are interested in the position, please email your resume to [email protected] for immediate consideration.