Clinical Pharmacist – Prior Authorization

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🔥 13 minutes ago

🌵 Arizona, California, +6 more states – Remote

🌵 Arizona – Remote 🏄 California – Remote 🌪️ Kansas – Remote 🎰 Nevada – Remote 🌶️ New Mexico – Remote 🌪️ Oklahoma – Remote 🤠 Texas – Remote ⛷️ Utah – Remote

💵 $94.5k - $193.6k / year

⏰ Full Time

🟢 Junior

💊 Pharmacist

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CVS Health

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1963

🏥 Healthcare

⚕️ Healthcare Insurance

🛒 Retail

Healthcare • Healthcare Insurance • Retail

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

• Review Prior Authorization requests • Verify proven and/or medically necessary indications • Review clinical documentation supporting prior authorization reviews • Provide internal pharmacist support to the PA team and member services department • Perform foreign drug reviews, medical record reviews, and case analysis • Provide clinical support and collaboration for new drug policy development and revisions to existing drug policies • Participate in clinical projects • Work a set schedule within the 5am–7pm AZT operating window • Potential future Saturday rotation • Potential on-site training

🎯 Requirements

• 1+ Years pharmacist experience in Pharmacy Benefit Management • 1+ Years pharmacist experience with Prior Authorizations • Active, unrestricted pharmacist licensure in the State of Arizona • Active, unrestricted pharmacist licensure in state of residence • PharmD or BS in Pharmacy • 40 hours per week availability • Ability to work a set schedule of 8-hour shifts five days per week or 10-hour shifts four days per week within 5am–7pm AZT • Preferred: 3+ Years in Pharmacy Benefit Management • Preferred: 2+ Years in Clinical Prior Authorizations • Preferred: Experience with RxClaim • Preferred: Demonstrated computer proficiency

🏖️ Benefits

• Medical coverage • Dental coverage • Vision coverage • Paid time off • Retirement savings options • Wellness programs • Other resources supporting physical, emotional, and financial well-being • CVS Health bonus, commission or short-term incentive program in addition to base pay

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