Job Description:
• Evaluates and authorizes approval of prior authorization pharmacy requests from prescribers received by telephone and/or facsimile using client clinical criteria. Determines appropriateness for medications. Communicates decision to physicians, physician’s office staff, medical management staff, and/or pharmacists.
• Communicates selected prior authorization criteria, pharmacy benefit coverage, and formulary alternatives to physicians, physician’s office staff, medical management staff, and/or pharmacists.
• Researches, resolves, and documents prior authorization outcomes in the pharmacy system.
• Escalates requests to Pharmacist when request requires extensive clinical review or denial.
• Researches, resolves, and documents physician or client inquiries and grievances. Provides verbal or written results to client, prescriber, provider, and/or management.
• Performs other duties as required.
All your information will be kept confidential according to EEO guidelines.
Job details are sourced from the employer's original posting.
Open job postingAbout the company
Integrated Resources, Inc is a premier staffing firm recognized as one of the tri-states most well-respected professional specialty firms. IRI has built its reputation on excellent service and integrity since its inception in 1996. Our mission centers on delivering only the best quality talent, the first time and every time. We provide quality resources in four specialty areas: Information Technology (IT), Clinical Research, Rehabilitation Therapy and Nursing.