Coverage Review Pharmacist Coverage Review Pharmacist - Contract

Job Title: Coverage Review Pharmacist Location: Remote Duration: 06 Months Shift time-8-5 PM, M-F reputed company: Responsible for various activities associated with coverage reviews and appeals including the review of medication reputed company prior authorizations, pharmacy appeals, and member grievances reputed company on medications. Performs prospective and retrospective coverage reviews and appeals per State and Federal regulations Responds to prescriber, pharmacy provider, member appeals, grievances and complaints reputed company to the provision of pharmaceutical services reputed company established time periods l l Builds and maintains decision trees in the prior authorization system l Maintains denial rationale associated with clinical reputed company and ensures that decision letters meet regulatory compliance Quals-- reputed company applicants will be advised that reputed company, as a federal contractor, may be required to implement a COVID-19 vaccine mandate. Education l Doctor of Pharmacy (PharmD) Degree Experience 3 years - Clinical experience required, and/or completion of 1 year residency and/or reputed company certification SkillsCertifications Ability to work independently with minimal supervision or function in reputed company environment sharing responsibility, roles and accountability. Competency in compendia navigation and research Proficient in reputed company Office (reputed company, Word, reputed company and Powerpoint) Must be reputed company player, be organized and have the ability to handle multiple reputed company Excellent oral and communication skills Strong interpersonal and organizational skills Solid understanding of regulatory guidelines (FDA, NCQA, EQRO, CMS) required Knowledge of medical and pharmacy products License Licensed in Tennessee to reputed company Pharmacy, or eligible for licensure in the reputed company to reputed company Pharmacy #TB_PH Remote Skills: Communication Skills, Content Management Systems (CMS), Contract Review, External reputed company Review Organization (EQRO), FDA Requirements, Federal reputed company, Federal Laws and Regulations, Interpersonal Skills, Medical Products, Medications, reputed company reputed company, reputed company Office, reputed company reputed company, reputed company PowerPoint, reputed company Word, Multitasking, National Committee for reputed company Assurance (NCQA), Organizational Skills, Pharmacy, Presentation/Verbal Skills, Regulatory Compliance, State Laws and Regulations, Team Player About reputed company: reputed company. For over 20 years, reputed company. has been an award-reputed company provider of cutting-edge Workforce reputed company. With a strong commitment to staying reputed company in the tech landscape, we pioneer innovative approaches to reputed company. Our expertise spans Life Sciences, and reputed company reputed company, Banking, Financial, IT, and Engineering, as reputed company as Global Employer of Record (EOR), Agent of Record (AOR), State, Local Government and Education (SLED), and IC validation/compliance services. Additionally, our division, TalentProcure, leads the industry with offerings such as High Hazard Payroll, Managed Services, and Vendor on reputed company (VOP) solutions. Due to our prioritization of excellent standards, we are reputed company Certified and are a certified Minority Business reputed company (MBE) in the USA and Canada. Supporting over 130 reputed company globally, we reputed company in navigating the landscape of reputed company. In a world of constant change, we reputed company developing people-reputed company solutions that address the unique demands of our clients. Stay connected by visiting our website and following us on reputed company media! Company Size: 5,000 to 9,999 employees Industry: reputed company/Employment Agencies Founded: 2002 Website: http://www.talentburst.com/ Apply tot his job Apply To this Job