Prior Authorization Pharmacist (Remote)

MRIoA • Mountain View, CA

5h • Remote

About The Position

Founded in 1983, we’re a clinically-driven, tech-enabled utilization management company offering expert clinical reviews, regulatory guidance, and actionable insights to healthcare organizations.

Excellence starts with our people.

The PA Pharmacist is an important member of the pharmacy department. The PA Pharmacist works alongside the Supervisor, PA Pharmacists to set and meet production goals and to ensure each prior authorization is completed on time and in accordance with the individual client’s prior authorization criteria. The PA Pharmacists also serve as a drug information resource for MRIoA physicians and reviewers.

Requirements

• Possess a strong drug knowledge and able to clinically evaluate all drug authorization requests correctly
• Ability to work in a fast-paced and high-functioning environment and meet deadlines while managing multiple high priorities
• Personal computer literacy and high competency in use of Microsoft Word and Excel
• Strong organizational skills with attention to details
• Strong oral and written communication skills
• Well-developed training skills
• Strong working knowledge of medical insurance terminology and processes
• Excellent critical thinking capabilities with a strong attention to detail
• Exceptional customer service skills
• Minimum two years of experience as a pharmacist preferred
• Credentialed and privileged by the company's credentialing committee
• Willingness to obtain additional state licensure as required for the position
• PharmD
• Pharmacist license in good standing
• Ability to sit at a desk, utilize a computer, telephone, and other basic office equipment is required.

Nice To Haves

• Pharmacy Benefit Management experience preferred

Responsibilities

• Perform case reviews for prior authorizations
• Complete Peer-to-Peer reviews with healthcare professionals regarding the outcomes of prior authorizations
• Serve as an active member of client committees, as requested
• Monitor prescription turnaround time so that internal standards and client performance guarantees are met
• Serve as a resource for team members for clinical and drug information
• Assist in implementing programs and process improvements to enhance the level of internal and external customer service provided
• Provide a high-quality review of requested medication with clear notes of determination
• Communicate with team and Supervisor, PA Pharmacist as appropriate to proactively inform of issues or concern
• Recognize and recommend operational improvements
• Other special projects and tasks as assigned

Benefits

• A competitive compensation package.
• Benefits include healthcare, vision and dental insurance, a generous 401k match, paid vacation, personal time, and holidays.
• Growth and training opportunities.
• A team atmosphere with fun events and prizes scheduled throughout the year.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Ph.D. or professional degree