Clinical Pharmacist – Prior Authorization

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🔥 0 minutes ago

🤠 Texas – Remote

🤠 Texas – Remote

💵 $50 - $84 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

💊 Pharmacist

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CVS Health

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1963

⚕️ Healthcare Insurance

🛒 Retail

🧘 Wellness

Healthcare Insurance • Retail • Wellness

CVS Health is a leading American healthcare company dedicated to improving health access and affordability. The company focuses on a comprehensive approach that includes health services, health insurance, and pharmacy benefits management. Through its subsidiaries, such as Aetna and CVS Caremark, CVS Health offers a range of services that facilitate wellness, condition management, and affordable prescription drug coverage. CVS Health operates neighborhood pharmacies, provides mail-order pharmacy services, and manages specialty medication programs, aiming to make healthcare convenient and accessible for everyone. Driven by a mission to connect people with essential care services, CVS Health is committed to fostering healthier communities and supporting the wellbeing of all individuals.

📋 Description

• Collaborates with the technicians and prior authorization team members to process referrals • Evaluate and review all prior authorization requests and render coverage determinations based on clinical criteria and plan design • Guarantee that decisions regarding cases are conveyed promptly and efficiently • Performs and handles inbound and outbound phone calls with technicians, prior authorization team members, physicians, healthcare providers, and/or patients • Establishes and maintains communication among CVS Caremark, health plan, and employer group staff • Maintains professional and technical knowledge of drug and disease states • Performs other related projects and duties as assigned

🎯 Requirements

• Active, unrestricted pharmacist licensure • Current pharmacist experience within Caremark PA Ops required • Ability and willingness to work a flexible hourly schedule to include overtime, weekends, and holidays as needed • Knowledge of Microsoft Office Suite: Excel and Word required; Access, Outlook, PowerPoint, Visio preferable • Keyboard skills essential • Must be able to multitask and utilize multiple system applications simultaneously • Must be able to utilize available resources independently and provide high quality work • Must demonstrate problem solving ability and attention to detail • Ability to adapt and change with workflow and shifting priorities • Ability to work effectively in a team environment and provide mentorship to non-clinical staff on the prior authorization team • Must possess excellent written, verbal, grammar, and listening communication skills • Must be able to effectively communicate with a diverse customer base (internal and external) in a friendly and confident manner • Ability to maintain confidentiality of PHI (Protected Healthcare Information)

🏖️ Benefits

• medical, dental, and vision coverage • paid time off • retirement savings options • wellness programs • other resources, based on eligibility