Contract role through April 2027 will most likely extend
*Must be Doctor of Pharmacy
*Must have PBM/Prior Authorization experience
*Must be willing to work one Saturday or Sunday after training- Business hours option for 5 8 hour days or 4 10 hour days after training
*Must have no time off needed in first 4-6 weeks of training and busy season January to April 2027
60 per hour nonnegotiable
Primary Duties and Responsibilities
• Review and render decisions on authorizations and appeals for pharmacy drug requests
• Conduct peer-to-peer calls with prescribers to discuss the clinical rationale of adverse determinations
• Participate in clinical quality audits and inter-rater reliability testing
• Provide internal team support for escalations and questions
• Apply clinical expertise to ensure appropriate and safe use of pharmaceuticals by members and providers
• Compliance with all applicable laws and regulations
• Other duties as assigned
Requirements
• 3+ years of experience as a licensed pharmacist
• Active, unrestricted pharmacist license
• Doctor of Pharmacy Degree
• Willingness to obtain licensure/training with new states, as needed
*Must have experience with Prior Authorizations
Contract through April 2027 (subject to business needs)
Shifts:
• At least one weekend shift per week, such as every Saturday or every Sunday
• Those working weekends have the option to do four 10-hour shifts or five 8-hour shifts
• Shift during training will be M-F; switch to weekend shift will be around 2 months after start date
• Training will be in the format of group class training
• Group class training will be 4-6 weeks
• Request for no PTO during group training
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