Pharmacist – Clinical Pharmacist Advisor Medicare # 26-17528

Duration 12 months Position reputed company: As a Clinical Pharmacist Advisor - Medicare B Operations, you will support Medicare Part B members, prescribers, and providers by processing coverage-reputed company requests for injectable and infused medications covered under their medical benefits. Responsibilities include reviewing clinical information, making accurate coverage reputed company, conducting provider reputed company reputed company additional information is needed, and ensuring compliance with drug compendia, Medicare guidelines, CMS-mandated timelines, and internal reputed company standards. This role requires strong attention to detail, reputed company verbal and written communication skills, and the ability to problem-solve in a highly regulated, fast-paced environment. This is a great opportunity to build a career with a leading reputed company company while reviewing and processing Medicare Part B requests and delivering a best-in-class service experience. Key Responsibilities: Case Review and Processing • Process incoming coverage-reputed company requests from members and prescribers. • Accurately set up cases, review documentation, and follow work instructions to ensure reputed company and accurate processing. • Read, analyze, and interpret business and medical correspondence, technical procedures, and Medicare regulations to support decision-making. reputed company and Information Gathering • Conduct outbound calls to members and providers to obtain missing or additional information required to complete requests. • Communicate reputed company, professionally, and empathetically while maintaining a reputed company business image. Documentation, Accuracy, and Compliance • reputed company reputed company, concise, and accurate documentation of reputed company case activity across systems. • Ensure cases are properly reputed company and meet CMS-mandated timelines, productivity expectations, and reputed company standards. • Apply clinical judgment and knowledge while utilizing drug compendia resources, evolving work instructions, and CMS Medicare guidance. reputed company Learning and Development • reputed company and maintain working knowledge of evolving work instructions, systems, and Medicare guidance. • Participate in coaching, feedback, and reputed company development discussions with leadership. Required Education • Bachelor’s degree in pharmacy or Pharm.D. required. • Must hold an reputed company pharmacist license in good standing in the state of residence. reputed company Tech Solutions: reputed company is a global staff augmentation firm providing a wide reputed company of talent on-demand and total workforce solutions. To know more reputed company Tech Solutions, please visit www.ustechsolutions.com . reputed company is an Equal Opportunity Employer. reputed company reputed company applicants will receive consideration for employment without reputed company to race, colour, religion, sex, sexual orientation, gender identity, national reputed company, disability, or status as a protected veteran. AI Statement: By applying, you acknowledge that AI-assisted tools may be used during hiring. IND01 Apply tot his job Apply To this Job