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Job Requirements of Pharmacist - Prior Authorizations:
-
Employment Type:
Contractor
-
Location:
Charleston, SC (Onsite)
Do you meet the requirements for this job?
Pharmacist - Prior Authorizations
Careers Integrated Resources Inc
Charleston, SC (Onsite)
Contractor
Job Title: Pharmacist - Prior Authorizations
Location: Charleston, NC 12345
Duration: 6+ Months (Possible Extension)
Location:
Shift: 11:00 am – 7:30 pm EST
Internet & Workspace Requirements:
Job Summary:
Key Duties:
Experience:
Education:
Certifications & Licensure:
Benefits:
Location: Charleston, NC 12345
Duration: 6+ Months (Possible Extension)
Location:
- Remote (Candidate can reside in any U.S. state)
- Must be licensed in the state of North Carolina.
Shift: 11:00 am – 7:30 pm EST
Internet & Workspace Requirements:
- Candidate must provide their own high-speed internet.
- Minimal home broadband connectivity: 25 Mb download / 3 Mb upload (verify at www.speedtest.net).
- Must provide Internet provider and download/upload speeds on resume.
- Must have a smartphone for VPN token download.
- Private, secure, and dedicated workspace for business use during work hours.
- Work area must protect confidential information and equipment.
- Computer must be shut off or locked when not in use.
Job Summary:
- Provides clinical review and authorization of prescriptions in accordance with plan design and clinical criteria.
- Utilizes clinical knowledge to ensure timely and accurate coverage determinations.
- Collaborates with technicians, prior authorization team members, physicians, and healthcare providers.
- Maintains up-to-date knowledge of drug and disease states for Specialty and Non-Specialty Pharmacy programs.
- Participates in training, development meetings, and on-call/after-hours coverage as needed.
Key Duties:
- Evaluate and review all prior authorization requests; render coverage determinations.
- Verify insurance coverage and eligibility; interpret clinical guideline criteria.
- Consult physicians and other healthcare providers when required.
- Ensure case decisions are communicated efficiently to providers, patients, and plans.
- Collaborate with technicians and team members to process referrals and collect clinical/medical data.
- Handle inbound and outbound phone calls for prior authorization requests and escalations.
- Maintain professional and technical knowledge of pharmacy programs.
- Perform other related projects and duties as assigned.
- Review patient profiles, drug interactions, sensitivities, and medication usage databases.
- Determine if prescriptions require physician clarification or intervention.
- Enter prescriptions into the system and assist with patient services as needed.
- Conduct quality assurance, controlled substance security, and hazardous waste procedures.
- Dispense prescriptions and perform final dispensing quality checks.
Experience:
- Minimum of 1 year of pharmacy experience in retail or hospital preferred.
- Home infusion therapy experience is a plus.
- Strong organizational, interpersonal, and detail-oriented skills.
- Basic computer proficiency required.
Education:
- Bachelor of Science in Pharmacy or Pharm.D.
Certifications & Licensure:
- Active Pharmacist license in North Carolina (must be listed on resume).
Benefits:
- Competitive benefits package including vacation, 10 paid holidays per year, health/dental/vision insurance, employee discounted stock purchase program, 401K, tuition reimbursement, and 20-30% employee discount at Client stores.
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