Clinical Pharmacist - Prior Authorization (AZ Licensed)
About The Position
The Clinical Pharmacist reviews prior authorization (PA) requests, verifies proven and/or medically necessary indications, and reviews clinical documentation in support of PA reviews. The role provides internal pharmacist support to the PA team and member services department, requiring excellent oral and written communication skills. Other work includes foreign drug reviews, medical record reviews, case analysis, clinical support and collaboration on new or revised drug policies, and clinical projects. This is a remote role, with potential on-site training, open to qualified candidates in the United States. The ideal candidate resides in the Phoenix, Arizona area. Candidates must hold active, unrestricted pharmacist licensure in Arizona. The role is 40 hours per week, working either five 8-hour shifts or four 10-hour shifts within operating hours of 5 a.m. to 7 p.m. Arizona time. A future Saturday rotation may be introduced.
Requirements
- At least 1 year of pharmacist experience in Pharmacy Benefit Management.
- At least 1 year of pharmacist experience with Prior Authorizations.
- Active, unrestricted pharmacist licensure in the State of Arizona.
- Active, unrestricted pharmacist licensure in the state of residence.
- PharmD or BS in Pharmacy.
Nice To Haves
- At least 3 years of experience in Pharmacy Benefit Management.
- At least 2 years of experience in Clinical Prior Authorizations.
- Experience with RxClaim.
- Demonstrated computer proficiency.
Responsibilities
- Review prior authorization requests.
- Verify proven and/or medically necessary indications.
- Review clinical documentation in support of prior authorization reviews.
- Provide internal pharmacist support to the prior authorization team and member services department.
- Perform foreign drug reviews, medical record reviews, and case analysis.
- Provide clinical support and collaborate on the development of new drug policies and revisions to existing drug policies.
- Participate in clinical projects.
Benefits
- Medical coverage
- Dental coverage
- Vision coverage
- Paid time off
- Retirement savings options
- Wellness programs
- Other resources, based on eligibility
- Eligibility for a CVS Health bonus, commission, or short-term incentive program
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What This Job Offers
Job Type
Full-time
