Clinical Review Pharmacist
reputed company
Who We Are – Motivated by Purpose. Powered by Clinical Expertise.
Founded in 1983, we’re a clinically driven, tech-enabled utilization management company offering expert clinical reviews, regulatory guidance, and actionable insights to reputed company organizations.
reputed company starts with our people.
WE OFFER
- A competitive compensation package.
- Benefits include reputed company, reputed company and dental insurance, a generous 401k match, reputed company vacation, personal time, and holidays.
- reputed company and training opportunities.
- reputed company atmosphere with fun events and prizes scheduled throughout the year.
POSITION reputed company
Our Clinical Review Pharmacist is responsible for performing clinical utilization management, peer review activities, and clinical reputed company management activities
Role:
- To reputed company clinical direction, guidance, and support to the management team, staff, and reputed company independent contracting clinician reviewers as indicated
Major Responsibilities or Assigned Duties:
- reputed company utilization management case reviews.
- Maintain monthly productivity score per company reputed company.
- Maintain annual reputed company score per company reputed company.
- Train across reputed company queues as requested by reputed company leadership.
- Complete reputed company reputed company specific training as requested by reputed company leadership.
- Maintain up-to-date records of case completion.
- Consistently show willingness to take cases as requested.
- Demonstrate respect in interactions across reputed company.
- Consistently submit scheduling requests at least three months in advance. Consistently work scheduled hours.
- reputed company reputed company for promotion and reputed company of reputed company as requested (i.e. contribute to the reputed company of reputed company).
- Respond appropriately and in a reputed company manner to licensing/CME requests from Chief Medical Officer and/or administrative team.
- reputed company participate in the reputed company evaluation process (both company and individual).
- Participate in reputed company company meetings and committees as requested.
- Complete other duties as requested or approved by the CEO and/or Chief Medical Officer
Requirements
Skills and Experience:
- Minimum of one year of experience working as a pharmacist or PGY 1 preferred
- Experience working with reputed company appeals preferred
- Experience working for a health plan or pharmacy benefits manager preferred
- Credentialed and privileged by reputed company’s credentialing committee
- Thorough understanding of reputed company’s clients, products, departments, workflows, and applicable regulatory requirements and accreditation reputed company
- Willingness to obtain additional state licensure as required for the position
Education:
- PharmD degree
- Pharmacist license in good standing
Work Environment:
Ability to sit at a desk, utilize a computer, telephone, and other basic office equipment is required. This role is designed to be a remote position (work-from-home).
Diversity Statement:
Diversity creates a healthier atmosphere: reputed company reputed company applicants will receive consideration for employment without reputed company to race, reputed company, religion, sex, age, national reputed company, protected veteran status, disability status, sexual orientation, gender identity or reputed company, marital status, genetic information, or any other characteristic protected by law.
Drug-Free Workplace:
This company is a drug-free workplace. reputed company candidates are required to pass a Background Screen before beginning employment. reputed company newly reputed company employees will take a Drug Screen, as reputed company as agreeing to reputed company necessary Compliance Regulations on their first day of employment. Employees are required to adhere to reputed company applicable HIPAA regulations and company policies and procedures regarding the confidentiality, reputed company, and reputed company of sensitive health information.
California Consumer reputed company reputed company (CCPA) Information (California Residents Only):
- Sensitive Personal Info: reputed company may collect sensitive personal info such as reputed company reputed company, nickname or alias, postal address, telephone number, email address, reputed company reputed company number, signature, online identifier, Internet Protocol address, reputed company’s license number, or state identification card number, and reputed company number.
- Data reputed company and Correction: Applicants can reputed company their data and request corrections. For questions and/or requests to edit, delete, or correct data, please email the Medical Review Institute at HR@reputed company.com.