Pharmacist

Clinical Pharmacist

Hours of Operation for the site: currently 7:00am - 7:30pm EST. workers will have one of the following shifts: following shifts (subject to change): 7:00am-3:30pm, 8:00am-4:30pm, 9:00am-5:30pm, 10:00am-6:30pm, 11:00am-7:30pm, OT typically voluntary based on volume of work, sometimes mandatory

Position Summary: Responsible for reviewing clinical coverage determination and appeals using Medicare and client specific requirements. Knowledgeable in all aspects of coverage determination and appeals process and assist in meeting clients expectations regarding efficiency, services levels, privacy maintenance and quality decision making. Work as part of the team to meet business unit objectives. The Pharmacist will be responsible for reviewing medication exception request, as well as completing data analysis and various clinical projects. Escalate issues to Coverage Determinations and Appeals management team as needed. Position will require schedule flexibility including rotations through nights, weekend and holiday coverage. All other duties are required to meet business needs.

Duties: Responsibilities 1.Review the information provided upon request by utilizing the designated tools (web based) for further research. High proficiency in computer skills is necessary including but not limited to Microsoft Word, Microsoft Excel, and web based programs. 60% 2.Outreach for additional information. May include Pharmacy, Prescribers, Members, etc. as appropriate 25% 3.Data Entry (Electronic Database) recording decision making, inputting clinical notation, request for additional information, faxes, summary, etc. 10% 4.Training - attending meetings, online job aides, process changes, new initiatives, communication, etc. both formal and informal training 5%

• Minimum of 6 months as a Pharmacist
• Must have an active Pharmacist License in the state of OH.

Apply Now and look for Ron Autor! 469-729-5756

All your information will be kept confidential according to EEO guidelines.