Mark Powers

Remote Pharmacist PharmD Appeals HealthCare Support is actively seeking Pharmacists for multiple Remote Pharmacist PharmD Appeals openings with one of our prestigious healthcare clients.  Must have prior MCO Appeals or Prior Authorization experience.   Daily Responsibilities for Remote Pharmacist PharmD Appeals:

• Interpret physicians' prescriptions and clinical documentation, accesses clinical criteria and compendia support
• Consult with customers, patients and/or physicians regarding use of medications, potential drug interactions, and clinical status for appeals requests
• Conduct Quality Assurance and verify the accuracy of all prescriptions to render appeal decision
• Provide explanations and interpretations within area of expertise
• Review formulary and utilization management guidelines to determine if the drug should be a covered benefit for the beneficiary based on their medical history
• Research, evaluate, and make determinations on member and provider appeals of pharmacy coverage decisions
• Monday to Friday 8AM - 5PM or 9AM - 6PM Local Times
• Contract 6+ months

Required Qualifications for Remote Pharmacist PharmD Appeals:

• Bachelor's degree in Pharmacy or Pharm.D. required
• Experience in Coverage Determinations (prior authorization) or member appeals. Specifically Appeals REQUIRED
• Must have an active license in good standing in state of residence
• Previous experience in Managed Care/PBM environment

Benefits for Remote Clinical Pharmacist Advisor - Part D:

• Health Insurance
• Dental Insurance
• Life Insurance
• Employee Assistance Program (EAP)
• Access to Investment Accounts

Pay Details: $65.00 to $70.00 An Hour Interested in Being Considered? If you are interested in applying to this position, please click Apply Now for immediate consideration. For additional questions, you may contact us at [email protected]. Please include your phone number, Job Title, and location and our recruiters will reach out. Healthcare Support Staffing, LLC is an equal employment opportunity employer and will consider all qualified applicants without regard to race, color, religion, disability, sex, sexual orientation, gender identity, national origin, protected veteran status, or any other characteristic protected by applicable local, state, or federal law.