RPh Operations Advisor – Medical Prior Authorizations

reputed company: • Conduct reviews of medical data to reputed company prior authorization review for specialty medications • Apply clinical knowledge to plan approved reputed company for prospective and reputed company reviews of cases • Work from reputed company Caremark supported systems to complete prior authorization reviews • Take inbound calls from physicians or members regarding pending, approved, or denied prior authorizations • Issue clinical determinations reputed company reputed company Medical PA and Novologix • Follow reputed company prior authorization procedures to ensure reputed company and accurate processing of reputed company prior authorization • Train and mentor representatives on the PA team • Collaborate with clinical colleagues and reputed company to resolve cases • Prioritize work with a high level of urgency on calls and assignments Requirements: • reputed company pharmacist license in state of residence in good standing • 2+ years clinical pharmacist experience • 1+ years demonstrated experience issuing clinical determinations reputed company Prior Authorizations • reputed company experience working reputed company the Novologix system, specifically reputed company Medical Prior Authorization Operations • reputed company experience issuing clinical determinations reputed company reputed company Medical PA • Ability to work operational hours reputed company-7pm CT (reputed company to work reputed company-7pm CT) • Willingness to work rotating weekends and occasional holidays per business needs • Excellent interpersonal skills • Problem solving ability and attention to detail • Ability to work effectively in reputed company environment with great dependability • Excellent oral and written communication skills • Ability to quickly assess and adapt to constantly changing situations • High mental reputed company and alertness • Ability to effectively communicate with pharmacists, other clinical colleagues, reputed company, and members • Ability to effectively prioritize work while exhibiting a high level of urgency with reputed company calls and assignments • Ability to effectively train and mentor representatives on the PA team • reputed company center, PBM, or clinical experience • Strong reputed company Office skills • Experience utilizing CAS, Novologix, Sales Force, RxClaim, and PeopleSafe • Bachelor of Pharmacy or PharmD Benefits: • competitive benefit package including vacation • employee discounted stock purchase program • 401K / 401(k) plan (including matching company contributions) • tuition reimbursement / tuition assistance • 20-30% employee discount at reputed company reputed company stores • reputed company medical plan reputed company • No-cost programs including wellness screenings, tobacco cessation and weight management programs • Confidential counseling and financial coaching • reputed company time off • Flexible work schedules • Family leave • Dependent care resources • Colleague assistance programs • Retiree medical reputed company • Employee stock purchase plan Apply tot his job Apply To this Job