HC - PHARMACIST - INTERMEDIATE

The Judge Group - New York, NY

Full-time - Entry Level

Remote - New York, NY

Administrative and Support Services

About the position

The Clinical Pharmacist position in the Prior Authorization unit is a remote role focused on reviewing prior authorization cases and making coverage determinations based on clinical criteria and plan design. This position operates within a call center environment, requiring adherence to strict work guidelines while providing excellent customer service and maintaining compliance with pharmacy laws and regulations.

Responsibilities

• Receive phone calls from prior authorization pharmacy technicians and/or providers for clinical information.
• Consult with physicians/providers to interpret clinical guideline criteria and render/review coverage determinations for prior authorization cases.
• Advise pharmacy technicians and/or physicians on medication use and appropriate formulary alternatives when requested.
• Gather complex clinical information and work within regulatory guidelines to make coverage determinations.
• Organize workload, set priorities, and complete assignments in a timely manner while complying with department standards.
• Perform all duties in compliance with state and federal pharmacy laws and regulations.
• Support department quality assurance and improvement guidelines.
• Build rapport with coworkers and internal customers, demonstrating a strong customer service orientation.

Requirements

• Active state Pharmacist license.
• Ability to work with PC, including using a mouse and keyboard, and navigating multiple systems and screens.
• Excellent attendance record.

Nice-to-haves

• Experience in a call center environment.
• Familiarity with prior authorization processes.

Benefits

• Scheduled overtime opportunities.
• Potential for working on holidays.