Job Description
Hiring for Fully Remote Pharmacist
Well-known PBM | Excellent Opportunity to WFH | Clinical Review Experience
We are seeking a dedicated Clinical Pharmacist to join our team in a fully remote capacity. You will be responsible for reviewing utilization management requests and making informed decisions based on client-specific criteria. This role requires precision, clinical judgment, and effective communication with healthcare providers and team members.
Responsibilities
+ Review and evaluate commercial members’ utilization management requests, including formulary exceptions, prior authorization, step therapy, and quantity limit exceptions.
+ Utilize client-specific criteria to determine approval or denial of prior authorizations.
+ Conduct clinical evaluations for coverage determination requests, considering denial language and decision appropriateness.
+ Consult directly with healthcare providers or members on non-formulary and clini...
Well-known PBM | Excellent Opportunity to WFH | Clinical Review Experience
We are seeking a dedicated Clinical Pharmacist to join our team in a fully remote capacity. You will be responsible for reviewing utilization management requests and making informed decisions based on client-specific criteria. This role requires precision, clinical judgment, and effective communication with healthcare providers and team members.
Responsibilities
+ Review and evaluate commercial members’ utilization management requests, including formulary exceptions, prior authorization, step therapy, and quantity limit exceptions.
+ Utilize client-specific criteria to determine approval or denial of prior authorizations.
+ Conduct clinical evaluations for coverage determination requests, considering denial language and decision appropriateness.
+ Consult directly with healthcare providers or members on non-formulary and clini...