Clinical Pharmacist-Fully Remote
5+ years
United States
Full-time
Remote
1 month ago
About the role
I’m helping LanceSoft find a top candidate to join their team full-time for the role of Clinical Pharmacist-Fully Remote .
You'll ensure timely, accurate coverage determinations, directly impacting patient care and healthcare provider efficiency.
Compensation:
USD 55 - 58/hour
Location:
Remote: United States
Mission of LanceSoft:
"LanceSoft’s mission is to establish global cross-culture human connections that further the careers of our employees and strengthens the businesses of our clients. We are driven to use the power of our global network to connect businesses with the right people, and people with the right businesses without bias. We provide Global Workforce Solutions with a human touch."
What makes you a strong candidate:
Responsibilities and more:
Job Title: Clinical Pharmacist (Prior Authorization/PBM)
Duration: 5 plus month with possible extension
Location: Fully Remote
Pay Range: $55- $58.00/hr
The basic function of the pharmacist is
Review and complete criteria based on prior authorization as per policy and procedure.
This position is for a Clinical Pharmacist working in the Prior Authorization team.
This Pharmacist will:• Evaluate and review all prior authorization requests and render coverage determinations based on clinical criteria and plan design. Includes verifying insurance coverage and eligibility, interpreting clinical guideline criteria, consulting physicians and other healthcare providers, and appropriately utilizing clinical knowledge and resources while complying with department protocols.
One of the crucial responsibilities is to guarantee that the decisions regarding cases are conveyed promptly and efficiently to all the healthcare providers, health plans/employers, patients, and other healthcare professionals following agreed-upon approval & denial management processes.
• Collaborate with the technicians and prior authorization team members to process referrals, including answering clinical questions and collecting appropriate clinical/medical data needed to perform clinical assessments and reviews as per the health plan/employer- agreed criteria within the designated service level agreements.
Performs and handles in¬ bound and outbound phone calls with technicians, prior authorization team members, physicians, healthcare providers, and/or patients to facilitate prior authorization requests, answer inquiries, and/or resolve escalations.
Your potential leader(s):
You'll ensure timely, accurate coverage determinations, directly impacting patient care and healthcare provider efficiency.
Compensation:
USD 55 - 58/hour
Location:
Remote: United States
Mission of LanceSoft:
"LanceSoft’s mission is to establish global cross-culture human connections that further the careers of our employees and strengthens the businesses of our clients. We are driven to use the power of our global network to connect businesses with the right people, and people with the right businesses without bias. We provide Global Workforce Solutions with a human touch."
What makes you a strong candidate:
- You are proficient in Prior authorization, Pharmacy benefits, Medication therapy management, Clinical assessments.
- You have the potential to develop in Utilization review.
- English - Conversational
Responsibilities and more:
Job Title: Clinical Pharmacist (Prior Authorization/PBM)
Duration: 5 plus month with possible extension
Location: Fully Remote
Pay Range: $55- $58.00/hr
The basic function of the pharmacist is
Review and complete criteria based on prior authorization as per policy and procedure.
This position is for a Clinical Pharmacist working in the Prior Authorization team.
This Pharmacist will:• Evaluate and review all prior authorization requests and render coverage determinations based on clinical criteria and plan design. Includes verifying insurance coverage and eligibility, interpreting clinical guideline criteria, consulting physicians and other healthcare providers, and appropriately utilizing clinical knowledge and resources while complying with department protocols.
One of the crucial responsibilities is to guarantee that the decisions regarding cases are conveyed promptly and efficiently to all the healthcare providers, health plans/employers, patients, and other healthcare professionals following agreed-upon approval & denial management processes.
• Collaborate with the technicians and prior authorization team members to process referrals, including answering clinical questions and collecting appropriate clinical/medical data needed to perform clinical assessments and reviews as per the health plan/employer- agreed criteria within the designated service level agreements.
Performs and handles in¬ bound and outbound phone calls with technicians, prior authorization team members, physicians, healthcare providers, and/or patients to facilitate prior authorization requests, answer inquiries, and/or resolve escalations.
Your potential leader(s):
- Nirmalak - Recruiting Lead at LanceSoft, Inc.
Skills
Staffing and RecruitingHealth Care Provider