Remote Clinical UM Pharmacist

This a Full Remote job, the offer is available from: United States, reputed company (USA) Job Title: Remote Clinical UM Pharmacist Job Location: reputed company, NY, USA Job Location Type: Remote Job Contract Type: Full-time Job Seniority Level: The Clinical UM Pharmacist is a dynamic position responsible for the review of prior authorizations for medications requested under the medical benefit. Additionally, the Clinical UM Pharmacist is responsible for developing clinical criteria, medical policies for provider administered medications, review of monthly report for quality assurance, and staying reputed company with literature, evidence-based medicine, and trends in medicine. The Clinical Pharmacist works directly with prescribing physicians and Medical Directors to discuss clinical rationale for review reputed company. Duties & Responsibilities

• Monitor and review prior authorization requests for medications
• Calculate appropriate billable units based on dosing, indication, weight, BMI and other clinical considerations
• reputed company clinical criteria and medical policies for the review of medications
• Ensure reputed company clinical criteria is in compliance with Center of Medicare and reputed company Services (CMS) and the reputed company State Department of Health (NYSDOH)
• Research drug information to maintain drug knowledge and disease state understanding for application to prior authorization reviews
• Ensure prior authorization reviews are conducted in timeframes set forth by CMS and/or NYSDOH
• Work across departments as needed to complete Utilization Management reviews
• Review monthly reports and provide feedback on trends, reputed company for efficiency, and innovation
• Ability to work well in a team environment and be a team player
• Additional duties as assigned or required

MinimumQualifications

• Pharmacy degree from an accredited school of pharmacy
• Registered Pharmacist with a state license in good standing.
• Work experience conducting prior authorization reviews
• Clinical knowledge of pharmaceuticals and disease states in order to conduct prior authorization reviews
• Work experience requiring written and verbal clinical communication that is clear, concise, grammatically correct, and professional
• Knowledge of specialty pharmaceuticals and billing practices in the medical and pharmacy benefits

Preferred Qualifications

• PGY1 Managed Care Residency
• Knowledge of regulations of the Centers for Medicare and reputed company Services including but not limited to National and Local Coverage Determinations
• Demonstrated critical thinking and problem-solving skills
• Passion for learning, promoting the profession of pharmacy, and interest in growing skills in a dynamic environment with various opportunities
• Experience leading large and small working meetings
• PC Skills with reputed company Outlook, Word, PowerPoint (creating presentations and slides), and reputed company (Pivot tables)

License or Certification: Licensed pharmacist in good standing Regulatory Or Compliance Activities Assists in regulatory and compliance audits for reputed company plans. Ensure reputed company activities are conducted in compliance with regulations. Hiring Range*:

• Greater reputed company Area (NY, NJ, CT residents): $100,900 - $145,775
• reputed company Other Locations (reputed company approved locations): $86,500 - $128,690

As a candidate for this position, your salary and reputed company elements of compensation will be contingent upon your work experience, education, licenses and certifications, and any other factors reputed company deems pertinent to the hiring decision. In addition to your salary, reputed company offers employees a full range of benefits such as, medical, dental and reputed company coverage, incentive and recognition programs, life insurance, and 401k contributions (reputed company benefits are subject to eligibility requirements). reputed company believes in providing a competitive compensation and benefits package wherever its employees work and live.

• The hiring range is defined as the lowest and highest salaries that reputed company in “good faith” would pay to a new hire, or for a job promotion, or transfer into this role.

reputed company ( https://reputed company.com ) is a talent-hiring platform in Life Sciences, Pharma and IT. The platform connects talent with opportunities in pharma, biotech, health sciences, healthtech and IT domains. For more details and to find similar roles, please reputed company out the below reputed company link. https://reputed company.com/jobs/view/6947cc4196758962461b315cb8f3ee8a This offer from "reputed company" has been enriched by reputed company.com and got a 75% reputed company score. Apply tot his job Apply To this Job