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Clinical Pharmacist – Prior Authorization
Location
Texas
Posted
2 days ago
Salary
$50 - $84 / hour
Seniority
Senior
Job Description
Clinical Pharmacist – Prior Authorization
CVS Health
• Collaborates with the technicians and prior authorization team members to process referrals • Evaluate and review all prior authorization requests and render coverage determinations based on clinical criteria and plan design • Guarantee that decisions regarding cases are conveyed promptly and efficiently • Performs and handles inbound and outbound phone calls with technicians, prior authorization team members, physicians, healthcare providers, and/or patients • Establishes and maintains communication among CVS Caremark, health plan, and employer group staff • Maintains professional and technical knowledge of drug and disease states • Performs other related projects and duties as assigned
Job Requirements
- Active, unrestricted pharmacist licensure
- Current pharmacist experience within Caremark PA Ops required
- Ability and willingness to work a flexible hourly schedule to include overtime, weekends, and holidays as needed
- Knowledge of Microsoft Office Suite: Excel and Word required; Access, Outlook, PowerPoint, Visio preferable
- Keyboard skills essential
- Must be able to multitask and utilize multiple system applications simultaneously
- Must be able to utilize available resources independently and provide high quality work
- Must demonstrate problem solving ability and attention to detail
- Ability to adapt and change with workflow and shifting priorities
- Ability to work effectively in a team environment and provide mentorship to non-clinical staff on the prior authorization team
- Must possess excellent written, verbal, grammar, and listening communication skills
- Must be able to effectively communicate with a diverse customer base (internal and external) in a friendly and confident manner
- Ability to maintain confidentiality of PHI (Protected Healthcare Information)
Benefits
- medical, dental, and vision coverage
- paid time off
- retirement savings options
- wellness programs
- other resources, based on eligibility
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