Prior Authorization Pharmacist, TN Licensed
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Job Description
Clinical pharmacist evaluating prior authorizations, step therapy, and formulary exceptions for UNITAS healthcare staffing and consulting solutions. Consulting providers and ensuring consistent utilization-management decisions.
Responsibilities:
- Process and document Utilization Management requests, including prior authorization, step therapy, and formulary exceptions
- Clinically evaluate and determine client Utilization Management requests
- Consider denial language and the appropriateness of decisions in relation to individual program criteria
- Consult directly with health care providers about non-formulary and clinical product coverage issues
- Collaborate with team members to promote consistency of clinical decisions across the pharmacist team
- Perform other duties as assigned
Requirements:
- Active Tennessee pharmacist license in good standing at TN Board of Pharmacy
- Doctor of Pharmacy (PharmD) or Bachelor of Science in Pharmacy degree
- Confident in making clinical decisions independently
- Ability to prioritize tasks and manage multiple projects simultaneously
- Motivated self-starter who does not require constant direction or feedback to drive results
- Flexibility to evolve in a dynamic working environment
- Proficient with learning new computer systems and using multiple monitors
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