Prior Authorization Pharmacist
Curant Health · Smyrna, GA · 4 days ago
On-siteHealthcareFull-time
Key Responsibilities
- Review and process prior authorization requests based on clinical criteria and member benefits.
- Cook up drug utilization review reports and ensure compliance with regulatory requirements.
- Handle clinical calls from Customer Care for medication-related prior authorizations.
- Manage PA appeals and ensure adherence to policies and procedures.
- Act as a clinical resource for internal teams, prescribers, and clients.
- Monitor and improve the quality and efficiency of the Coverage Determination process.
- Stay updated on clinical guidelines and provide relevant insights for program development.
- Serve as a supervisor for the Prior Authorization Department, ensuring operational efficiency and training.
- Develop and implement departmental protocols and training materials.
Qualifications
- A Doctor of Pharmacy (PharmD) with at least 2 years of experience and licensed in the state of practice.
- Prior experience with prior authorizations, clinical pharmacy, and managed care is preferred.
- Knowledge of PBM, formulary management, and 340B is a plus.
Why Work for Us?
- Competitive pay.
- Paid holidays.
- Benefits.
- Paid time off.
- A work/life balance.
- Paid parental leave.
- Recognition programs.
- Promotion opportunities.
- A comprehensive training program to enhance your career.
- Employee prescription discounts.