Retail Pharmacist - Prior Authorizations

ProMedica•Toledo, OH

9d•Remote

About The Position

This position will work remotely to support clinic and pharmacy locations, alongside Prior Authorization Billing Specialists. Reviews and supports prior authorizations, formulary exception requests, payer denials and appeals, and other medication access activities to facilitate timely and appropriate patient access to prescribed therapies. Performs clinical review of medication refill authorization requests and medication histories, ensuring accuracy, appropriateness, adherence to clinical guidelines, and effective communication with patients and providers regarding medication therapy. Provides transitions of care services through medication reconciliation, discharge medication review, identification and resolution of medication-related problems, patient education, and collaboration with providers to promote safe and effective transitions across care settings.

Requirements

Prior Authorization Billing Specialists support
Clinical review of medication refill authorization requests
Medication histories review
Medication reconciliation
Discharge medication review
Identification and resolution of medication-related problems
Patient education
Collaboration with providers

Responsibilities

Reviews and supports prior authorizations, formulary exception requests, payer denials and appeals, and other medication access activities to facilitate timely and appropriate patient access to prescribed therapies.
Performs clinical review of medication refill authorization requests and medication histories, ensuring accuracy, appropriateness, adherence to clinical guidelines, and effective communication with patients and providers regarding medication therapy.
Provides transitions of care services through medication reconciliation, discharge medication review, identification and resolution of medication-related problems, patient education, and collaboration with providers to promote safe and effective transitions across care settings.