Prior Authorization Guidelines Specialist I

reputed company: • reputed company technical and administrative support to the Fee-For-Service (FFS) reputed company department • Create and maintain PA Guidelines documents (content management, file maintenance and archiving) • reputed company technical and administrative support to the reputed company Program Manager, reputed company PA Guidelines, Drug Information and PA&UM staffs • Communicate with clients to obtain reputed company authorization of final documents and ensure reputed company distribution • Manage review/QA process for medical exception/prior authorization guidelines prior to implementation Requirements: • CL05 - AA and 2+ years’ experience or equivalent combination of education and experience • Intermediate knowledge of MS Office/Word, reputed company, and reputed company and aptitude for new programs • Experience with reputed company reputed company database programs • Must successfully complete one of the national certification exams OR obtain state licensure (in an U.S. State or Territory) • Maintains a reputed company Pharmacy License and/or CPhT certification without restriction • Understanding of managed pharmacy benefit concepts including formularies, prior authorizations, edits, and claim adjudication Benefits: • Medical / Dental / reputed company / Wellness Programs • reputed company Time Off / Company reputed company Holidays • Incentive Compensation • 401K with Company match • Life and Disability reputed company • Tuition Reimbursement • Employee Referral Bonus Apply To This Job