Prior Authorization Pharmacy Specialist I

🔥 0 minutes ago

🐊 Florida – Remote

🐊 Florida – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

💊 Pharmacist

👻 Ghost score 10%

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Florida Cancer Specialists & Research Institute

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Florida Cancer Specialists & Research Institute is a leading organization in medical oncology and hematology. They are dedicated to providing exceptional cancer care through advanced treatment options, including chemotherapy, immunotherapy, and clinical trials. With a focus on personalized medicine, they tailor treatment to each patient's unique needs and facilitate access to numerous clinical trials, including those that lead to new cancer drug approvals. FCS operates numerous locations throughout Florida, allowing patients to access groundbreaking therapies close to home. Committed to excellence and innovation, FCS has earned national accreditation and a reputation for compassionate and effective patient care.

📋 Description

• Perform prior authorizations and appeals for oral oncology and supportive medications • Interact with patients, caregivers, and healthcare providers regarding prescription status inquiries • Assist pharmacy staff and healthcare professionals with prescription processing • Demonstrate effective communication and customer service with internal and external parties • Perform clinical chart reviews using appropriate criteria to complete prior authorizations • Process appeals for prior authorization denials according to insurance plan requirements • Provide documentation and compose letters of medical necessity when appropriate • Obtain approvals through online authorization sites, fax, and phone • Interpret or deviate from standard clinical data procedures when needed • Escalate complex clinical concerns to the appropriate clinician • Comply with accreditation standards, laws, regulations, and company policies • Participate in the pharmacy’s Continuous Quality Improvement program by identifying and reporting quality events • Perform additional tasks supporting the team and FCS

🎯 Requirements

• High school diploma or GED required • Active Registered Florida Pharmacy Technician license and state of residence required • Active National Pharmacy Technician Certification required • Prior Authorization Certified Specialist (PACS) certification preferred • Minimum three (3) years’ experience working in a health care or customer service-related field, preferably pharmacy or call center • Pharmacy benefit prior authorization experience preferred • Hematology/oncology experience preferred • Effective verbal and written communication • Strong interpersonal skills • Solid time management and ability to prioritize multiple tasks • Ability to collaborate across management levels, departments, and teams • Ability to negotiate problems and explore solutions with physician population • Compliance with patient privacy, federal and state laws, regulations, and company policies • Successful background screening and drug testing • Ability to meet vaccination requirements, barring an approved exemption

🏖️ Benefits

• Significant professional opportunities • Career advancement • Training • Competitive wages • Tuition reimbursement • 401-K match • Pet insurance • Legal insurance • Influenza vaccination requirement, barring an approved exemption • Background screening and drug testing as conditions of employment

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