Prior Authorization Pharmacist, TN Licensed

This is a fully remote position, open to applicants in Tennessee, +1 more state.

📋 Description

• Handle and document requests for Utilization Management, including prior authorizations, step therapy, and formulary exceptions.

• Conduct clinical evaluations to assess and determine client Utilization Management requests.

• Assess denial language and the suitability of decisions in relation to specific program criteria.

• Engage directly with health care providers regarding issues related to non-formulary and clinical product coverage.

• Work collaboratively with team members to ensure consistency in clinical decisions throughout the pharmacist team.

• Carry out additional duties as assigned.

⛳️ Requirements

• Valid Tennessee pharmacist license in good standing with the TN Board of Pharmacy.

• Doctor of Pharmacy (PharmD) or Bachelor of Science in Pharmacy degree.

• Ability to make independent clinical decisions with confidence.

• Skill in prioritizing tasks and managing multiple projects at once.

• Self-motivated individual who is able to achieve results without needing constant guidance or feedback.

• Adaptability to thrive in a fast-paced working environment.

• Proficient in learning new software systems and effectively using multiple monitors.

🏝️ Benefits

• Comprehensive health insurance plans.

• Competitive salary with performance-based incentives.

• Opportunities for continuing education and professional development.

• Flexible working hours and remote work options.