Per Diem Pharmacist

🔥 0 minutes ago

🇺🇸 United States – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

💊 Pharmacist

👻 Ghost score 10%

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EmpiRx Health

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 2014

🏥 Healthcare

💊 Pharmaceuticals

⚕️ Healthcare Insurance

Healthcare • Pharmaceuticals • Healthcare Insurance

EmpiRx Health is a clinically-driven, pharmacist-led pharmacy benefits management (PBM) company that focuses on medication optimization and value-based pharmacy care. The company centers pharmacists in its operating model, leveraging AI-powered analytics and population health tools to make evidence-based medication recommendations, improve patient outcomes, and reduce total drug spending for plan sponsors. EmpiRx offers a technology-enabled PBM platform and services to employers, health plans, and pharmacies, emphasizing customer-first service, guaranteed clinical savings, and preservation of community pharmacies.

📋 Description

• Act as a clinical expert on prior authorization review and evaluation according to clinical criteria and covered plan design • Review, evaluate, and resolve assigned clinical reviews through comprehensive case review and direct physician engagement • Perform peer-to-peer reviews with providers as needed or requested • Convey clinical determinations promptly to prescribers, members, and healthcare professionals following approval and denial protocols • Monitor and identify clinical interventions to ensure clinical savings guarantees are met • Review and evaluate current clinical literature to support recommendations and decision-making • Participate in continuous quality improvement initiatives • Stay informed on formulary updates, clinical programs, and internal policies • Provide guidance and support regarding clinical inquiries • Collaborate with clinical technicians and prior authorization team members to facilitate reviews, resolve escalations, and answer inquiries • Act as a clinical resource for internal staff and support staff training and development • Use pharmacy management software for case documentation and communications • Use Microsoft Office tools for analysis and reporting • Use external clinical and drug information resources, including IPD, Policy Reporter, UpToDate, and MediSpan • Collaborate cross-functionally on claim/data review, clinical interventions, and provider/member/client support

🎯 Requirements

• Pharm.D. degree from an accredited college of pharmacy (Required) • Minimum of 3 years of pharmacy experience in clinical, PBM, or managed care settings • Prior experience with prior authorization, utilization management, or health plan operations preferred • Active Pharmacist License in good standing (Required) • Strong clinical judgment and analytical thinking skills • Exceptional written and verbal communication • High attention to detail and accuracy in documentation • Excellent organizational and multitasking abilities • Proficient in Microsoft Office Suite and pharmacy systems • Ability to work independently and collaboratively in a fast-paced environment • Ability to work up to 25 hours a week from the hours of 8am-8pm EST

🏖️ Benefits

• Paid Time Off • 401(k) program • Health Insurance including Dental & Vision coverage • Health Savings Account • Employee Assistance Program