Job Description

Job Description

Job Description

FULLY REMOTE - WORK FROM HOME, 40 hours per week.

Job Highlights

• 100% Remote / Work from Home - can be located anywhere in the USA
• Contract to Hire with room for growth!
• Compensation: $53 per hour ($110,240 estimated salary) - pay increases once converted to permanent

40 hours per week, the schedules available are:

1. Tuesday-Saturday 8am-4:30pm CST / 9am - 5:30pm EST / 6am - 2:30pm PST
2. Sunday-Thursday 8am-4:30pm CST / 9am - 5:30pm EST / 6am - 2:30pm PST
3. Monday-Friday 9:30am-6pm CST / 10:30am - 7pm EST / 7:30am - 4pm PST

Job Requirements:

• Pharmacist license in state of residence, active and in good standing
• Prior authorization experience in PBM or managed care environment
• Experience in PBM, Managed Care, or VA Veterans Hospital

Job Responsibilities

• Consult physicians/providers with questions, interpret clinical guideline criteria, and render/review coverage determination for prior authorization cases.
• Coordinates timely communication of case decision to physician, health-plan/employer, patient and other healthcare professionals following agreed upon approval & denial management processes.
• Handles inbound phone calls and escalations from physicians or patients regarding Prior Authorization.
• Establishes and maintains communication among, health plan and employer group staff.
• Performs other related projects and duties as assigned including on call and after hours pharmacist availability could be required.

• Pharmacist license in state of residence, active and in good standing
• Prior authorization experience in PBM or managed care environment
• Experience in PBM, Managed Care, or VA Veterans Hospital

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