Coverage Review Pharmacist
Location: REMOTE Salary: $50.00 USD Hourly - $58.00 USD Hourly Description: Our client is currently seeking a Fully Remote Coverage Review Pharmacist This job will have the following responsibilities: • Responsible for various activities associated with coverage reviews and appeals including the review of medication related prior authorizations, pharmacy appeals, and member grievances focused on medications. • Performs prospective and retrospective coverage reviews and appeals per State and Federal regulations • Responds to prescriber, pharmacy provider, member appeals, grievances and complaints related to the provision of pharmaceutical services within established time period • Builds and maintains decision trees in the prior authorization system • Maintains denial rationale associated with clinical criteria and ensures that decision letters meet regulatory compliance Qualifications & Requirements: • BA/BS degree in Pharmacy or Pharm D • Licensed in Tennessee to practice Pharmacy, or eligible for licensure in the state of Tennessee to practice Pharmacy • 3 years - Clinical experience required • Ability to work independently with minimal supervision or function in a team environment sharing responsibility, roles and accountability. • Competency in compendia navigation and research Qualified and interested candidates, please send your most updated resume to [email protected] for immediate consideration, and times you're available for a call to discuss the position. Thank you and I look forward to speaking with you By providing your phone number, you consent to: (1) receive automated text messages and calls from the Judge Group, Inc. and its affiliates (collectively "Judge") to such phone number regarding job opportunities, your job application, and for other related purposes. Message & data rates apply and message frequency may vary. Consistent with Judge's Privacy Policy, information obtained from your consent will not be shared with third parties for marketing/promotional purposes. Reply STOP to opt out of receiving telephone calls and text messages from Judge and HELP for help. Contact: [email protected] This job and many more are available through The Judge Group. Find us on the web at www.judge.com Remote About the Company: Judge Group The Judge Group Inc., is a leading professional services firm specializing in talent, technology, and learning solutions. We consult, staff, train, and solve. Through our work we make people and organizations better. Our services are successfully delivered through a network of more than 30 offices across the United States, Canada, and India. The Judge Group is proud to partner with the best and brightest companies in business today, including over 60 of the Fortune 100. We serve organizations in financial services, healthcare, life sciences, insurance, government (including aerospace and defense), manufacturing, and technology and telecommunications. If you would like to learn more about The Judge Group visit www.judge.com or call toll free (800) 360-4474. Company Size: 5,000 to 9,999 employees Industry: Computer/IT Services Founded: 1970 Website: Apply tot his job