Pharmacist - Prior Authorizations

Our Client, a Retail Pharmacy company, is looking multiple Pharmacists with prior authorization experience to work remotely. Responsibilities:

+ Evaluate and review all prior authorization requests and render coverage determinations based on clinical criteria and plan design.

+ Includes verifying insurance coverage and eligibility, interpreting clinical guideline criteria, consulting physicians and other healthcare providers, and appropriately utilizing clinical knowledge and resources while complying with department protocols.

+ One of the crucial responsibilities is to guarantee that the decisions regarding cases are conveyed promptly and efficiently to all the healthcare providers, health plans/employers, patients, and other healthcare professionals following agreed-upon approval & denial management processes.

+ Collaborate with the technicians and prior authorization team members to process referrals, including answering clinical question...

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