TPIS-Temporary Professional Integrated Services
51 - 200 employees
Founded 2005
💼 Consulting
🏥 Healthcare
🚘 Automotive
Consulting • Healthcare • Automotive
TPIS-Temporary Professional Integrated Services is a staffing and recruiting agency with over 16 years of experience in identifying qualified candidates for various industries including Banking, Automotive Dealerships, Telecommunications, Healthcare, Services, Legal Firms, and Call Centers. Their specialties include recruitment, consulting, training, service, talent management, operations, temporary recruiting, and regular recruiting.
Pharmacist
Job not on LinkedIn
🔥 0 minutes ago
🗣️🇪🇸 Spanish Required
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TPIS-Temporary Professional Integrated Services
51 - 200 employees
Founded 2005
💼 Consulting
🏥 Healthcare
🚘 Automotive
Consulting • Healthcare • Automotive
TPIS-Temporary Professional Integrated Services is a staffing and recruiting agency with over 16 years of experience in identifying qualified candidates for various industries including Banking, Automotive Dealerships, Telecommunications, Healthcare, Services, Legal Firms, and Call Centers. Their specialties include recruitment, consulting, training, service, talent management, operations, temporary recruiting, and regular recruiting.
📋 Description
• Manage outbound calls to providers. • Provide support for both Medicare and Retirement via phone and chat. • Reviewing clinical information submitted by providers to determine whether a medication meets plan-specific coverage criteria. • Evaluating factors such as diagnosis, previous therapies, treatment history, quantity requested, dosing, and clinical appropriateness. • Approving requests when criteria are met. • Issuing clinical denials when criteria are not met and plan regulations allow pharmacist-level decisioning. • Referring cases to a Medical Director when regulatory or client requirements mandate physician review before a denial can be issued. • Documenting clinical rationale and ensuring all decisions comply with client, state, federal, CMS, and accreditation requirements.
🎯 Requirements
• Valid Pharmacist license • 1+ years of experience in a related environment (i.e. office, administrative, clerical, customer service, etc.) using phones and computers as the primary job tools • Advanced Microsoft and Windows PC applications skills, which includes the ability to navigate and learn new and complex computer system applications • Available to work (40 hours/week) Monday- Friday. Flexible to work any of our 8 hour shift schedules during our normal business hours of (8:00am to 7:00pm ATL) • Bilingual Spanish/English proficiency
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