Prior Authorization Pharmacist
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Job Description
Prior Authorization Pharmacist reviewing medication requests for compliance with clinical guidelines. Collaborating with providers and internal teams to enhance utilization management processes.
Responsibilities:
- Review Prior Authorization requests from medical professionals to ensure alignment with Preferred Drug List (PDL) criteria and current clinical guidelines
- Support Peer to Peer discussions with medical providers to discuss Prior Authorization reviews
- Collaborates on the refinement of consultation scripting; solicits and utilizes input from those contacted toward scripting improvements
- Contributes to the success of the Clinical Call Centers and Prior Authorization department by assisting with the implementation and management of both written and verbal communications to members and physicians
- Is available for consultation on pharmacy-related questions and issues for others within the organization
- Contributes to program improvements by using continuous quality improvement processes
Requirements:
- PharmD or B.S. in Pharmacy with relevant Specialty background
- Registered Pharmacist with unrestricted respective State Licensure (Wisconsin Pharmacist License Preferred but not required)
- 4 years’ experience in clinical pharmacy
- Strong verbal and written communications skills
- Highly skilled with Microsoft Office products and ability to quickly learn proprietary systems
Benefits:
- generous, flexible vacation policy
- 401(k) employer match
- comprehensive health benefits
- educational assistance
- variety of leadership and technical development academies
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