Prior Authorization Clinical Pharmacist

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WellDyne

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 1990

🏥 Healthcare

💊 Pharmaceuticals

⚕️ Healthcare Insurance

Healthcare • Pharmaceuticals • Healthcare Insurance

WellDyne is a pharmacy benefit management (PBM) company that provides specialty pharmacy services, prescription discount solutions, utilization management, mail-order and central fill pharmacy operations, and outsourced pharmacy solutions. The company emphasizes clinical programs, adherence initiatives, data analytics, and personalized engagement to reduce drug costs and improve outcomes, particularly for high-cost specialty medications. With about 25 years of experience and locations in Lakeland, FL and Centennial, CO, WellDyne positions itself as an alternative to traditional PBM models by offering flexible plan design, dedicated account management, and industry-focused clinical expertise.

📋 Description

• Conduct clinical review processes for Prior Authorizations for WellDyne’s retail clients • Make decisions for clinical pharmacy reviews and answer questions from Account Teams and PA support staff • Maintain a comprehensive library of clinical forms for team use • Participate in formulary development, pharmacy service-related processes, and clinical programs • Practice in accordance with local, state, and federal rules and regulations • Support effective teamwork and attend pertinent meetings as necessary • Assist in training and developing other pharmacy personnel • Follow and help enforce company policies and procedures • Keep abreast of developments in the professional field • Maintain HIPAA confidentiality guidelines • Answer clinical drug information questions as requested

🎯 Requirements

• Valid Pharmacist License in good standing • Ability to become licensed in multiple states as required • Minimum two years of pharmacy experience • Familiarity with Microsoft Word, Excel, and Outlook • Drug Information background preferred • Attention to detail • Ability to communicate effectively, patiently, and courteously • Ability to handle multiple activities or interruptions simultaneously • Ability to work with pharmacists, other departments, customers, and management • Ability to work independently, make clinical decisions with little supervision, and meet daily deadlines • Minimum 100 Mbps download and 10 Mbps upload internet speed, verified by HR through a speed test • Ability to connect using a hard-wired Ethernet connection • Mobile device required for VPN push notifications and system support • Dedicated, quiet workspace minimizing background noise and distractions

🏖️ Benefits

• Medical, Dental and Vision Benefits • Medical Savings Account Options with Company match • 401K after 90 days of employment • Employee Assistance Program • Life and Supplemental insurance • Educational Reimbursement • Paid Time Off • Career Pathing • Potential eligibility for additional discretionary bonuses/incentives and equity in the Company