PharmacistThe Judge Group • United States
Pharmacist
The Judge Group • United States
1 day ago
Job type
- Full-time
Job descriptionUS licensed Pharmacist with minimum of 3-5 years health plan experience. Minimum of 3-5 years health insurance plan experience. Minimum of 3-5 years conducting utilization management reviews for medical and pharmacy prior authorization requests. Experience with reviewing and providing input into clinical pharmacy policies that define criteria required to support payer coverage decisions. Minimum of 5 years’ experience with Microsoft applications (Word, PowerPoint, Excel, etc.). Ability to work independently. Experience working in electronic medical records (EMR) systems.
About the Company
Our client is currently seeking a Licensed Pharmacist.
About the Role
Regulatory requirements to utilize a US based and US licensed resource to conduct UM reviews. US licensed Pharmacist with minimum of 3-5 years health plan experience and the Utilization Management / Prior Authorization experience required to be able to conduct clinical reviews of medical benefit and pharmacy drug reviews and issue either an approval or a recommendation to deny with supporting rationale for final decision by the health plan's MD. Provide clinical review and support of payer's pharmacy clinical policies.
Responsibilities
- Conduct clinical reviews of medical benefit and pharmacy drug reviews.
- Issue either an approval or a recommendation to deny with supporting rationale for final decision by the health plan's MD.
- Provide clinical review and support of payer's pharmacy clinical policies.
Qualifications
Required Skills
Preferred Skills
Pay range and compensation package
Rate : 60 / hr
Preferred Start Date : 11 / 03 / 2025
Duration : 3 months
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Pharmacist • United States
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