Prior Authorization Clinical Pharmacist
About the role
Under the direction of the Manager, Clinical Services, the Prior Authorization Clinical Pharmacist practices in accordance with local, state, and federal rules and regulations. This role handles the clinical review process for Prior Authorizations as it pertains to retail clients of WellDyne.
Responsibilities
- Accountable for decision-making for clinical pharmacy reviews, questions from Account Teams and PA support staff, as well as maintaining a comprehensive library of clinical forms for use by the team.
- Responsible for participating in formulary development, pharmacy service-related processes, and clinical programs in accordance with company policy to promote a positive customer experience.
- Practice in accordance with local, state, and federal rules and regulations.
- Contribute to and support an atmosphere of effective teamwork.
- Attend pertinent meetings when necessary.
- Assist in training and developing other pharmacy personnel.
- Follow and aid in enforcement of all company policies and procedures.
- Keep abreast of developments in the professional field.
- Respect and maintain confidentiality guidelines of HIPAA.
- Answer clinical drug information questions as requested.
Requirements
- A valid Pharmacist License, in good standing.
- Ability to become licensed in multiple states as required.
- Two years minimum of pharmacy experience.
- Familiarity with Microsoft Word, Excel, and Outlook.
- Drug Information background preferred.
Skills
- Attention to detail.
- Ability to communicate effectively, patiently, and courteously.
- Ability to handle multiple activities or interruptions at once.
- Focused team player who can work in conjunction with pharmacists, other departments, customers, and management.
- Work independently and make clinical decisions with little supervision while meeting daily deadlines.
Remote Work Requirements
- Internet Speed: Minimum of 100 Mbps download / 10 Mbps upload, verified by HR through a speed test.
- Connectivity: Must be able to connect using a hard-wired Ethernet connection (modem/router must be within 10 feet to allow for a wired setup).
- Phone Access: A mobile device is required to receive VPN push notifications and for system support.
- Workspace: A dedicated, quiet workspace that minimizes 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.
Pay
Base Salary Range: $99,000.00–$129,000.00. In accordance with applicable state and federal laws, the range provided is WellDyne's reasonable estimate of the base compensation for this role. The actual amount may differ based on non-discriminatory factors such as experience, knowledge, skills, abilities, and location. Base pay is one part of the total package that is provided to compensate and recognize employees for their work, and this role may be eligible for additional discretionary bonuses/incentives, and equity in the Company.
Work Environment / Physical Demands
This position is in a typical office environment which requires prolonged sitting in front of a computer. Requires hand-eye coordination and manual dexterity sufficient to operate standard office equipment including operation of standard computer and phone equipment.