Clinical Pharmacist.
Immediate need for a talented Clinical Pharmacist. This is a 06+months contract opportunity with long-term potential and is located in NC(Remote). Please review the job description below and contact me ASAP if you are interested. Job ID: 26-14274 Pay Range: $58/hr - $60/hour. Employee benefits include, but are not limited to, health insurance (medical, dental, vision), 401(k) plan, and paid sick leave (depending on work location). Key Responsibilities:
- Review prior authorization requests and make determinations for drug products according to member benefits and coverage criteria
- Report to utilization review statistics to corporate compliance committees
- Review data and summarize daily utilization review numbers
- Responsible for tracking compliance of review cases
- Provide clinical guidance and support to the assigned pharmacy technicians
- Knowledge of drug coding (NDC, GCN, GPI and USC) and NCPDP claims adjudication systems
- Review guideline criteria for prior authorization and non-formulary drugs in support of Pharmacy and Therapeutics Committee function and pharmacy benefit design.
- Ensure and evaluate quality controls and implement opportunities for performance improvement in pharmacy practices
- Research drug information to maintain drug knowledge and disease state understanding for application to prior authorization reviews Hiring Requirements
Key Requirements and Technology Experience:
- Key skills; Must have Clinical Pharmacist License for NC.
- Bachelor's degree or advanced degree
- 3+ years of experience in related field.
- Current states pharmacy license.
- Industry Specific
: Retail, HMO, DSNIP
- Able to work on computer and has work from home experience + Pharmacist experience + High volume calling experience
- Medicare and Medicaid experience, Health Plan managed care experience MTM/CMR
- Typical Day : Participating
in comprehensive medication review. Cold calling members and reaching out on non-adherence.
- Advocate for member on adherence gaps.
- Time that you will be on the phone is going to be 3.5 to 4.5 hours a day
Our client is a leading Healthcare Industry, and we are currently interviewing to fill this and other similar contract positions. If you are interested in this position, please apply online for immediate consideration. Pyramid Consulting, Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. By applying to our jobs you agree to receive calls, AI-generated calls, text messages, or emails from Pyramid Consulting, Inc. and its affiliates, and contracted partners. Frequency varies for text messages. Message and data rates may apply. Carriers are not liable for delayed or undelivered messages. You can reply STOP to cancel and HELP for help. You can access our privacy policy here. Apply To This Job