Full-Time Pharmacist I - R7742
CareSource is hiring a remote Full-Time Pharmacist I - R7742. The career level for this job opening is Manager and is accepting USA based applicants remotely. Read complete job description before applying.
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CareSource
Job Title
Pharmacist I - R7742
Posted
Career Level
Full-Time
Career Level
Manager
Locations Accepted
USA
Salary
YEAR $90500 - $158400
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Job Details
About the job
Job Summary
Pharmacist I is responsible for supporting the department, operational strategies, goals and vision. Pharmacists shall utilize pharmaceutical and clinical expertise to review Prior Authorizations requests within a timely manner, to promptly serve our CareSource members.
Essential Functions
Pharmacist I is responsible for supporting the department, operational strategies, goals and vision. Pharmacists shall utilize pharmaceutical and clinical expertise to review Prior Authorizations requests within a timely manner, to promptly serve our CareSource members.
Essential Functions
- Supports and participates in Prior Authorization (PA) Reviews by documenting, implementing and utilizing the following: Formulary Management guidelines, Utilization Management programs, CareSource Administrative and Operational policies and procedures, and/or other clinical programs
- Execute critical thinking and decision processes when evaluating PA Reviews for Pharmacy and Medical Benefit medications
- Conduct PA Reviews for Multi-State Medicaid and Marketplace lines of business
- Provide written communications to members and providers upon decisioning of PA requests
- Engage Providers in “Peer to Peer” discussions, and Clinical Consults, as requested
- Assist Pharmacy PA call center staff
- Provide support and collaborate with pharmacy technicians to ensure operational efficiencies
- Adhere to Turn Around Time (TAT) requirements, per Line of Business
- Observe Operational Productivity Goals and Metrics
- Maintain exceptional quality
- Cross-collaborate with Departmental and Organizational Teams
- Perform any other job duties as requested
- Bachelor’s Degree in Pharmacy is required; Doctor of Pharmacy (PharmD) is preferred
- Minimum of three (3) years of retail pharmacy experience is preferred
- Minimum of one (1) year managed care or Medicare experience is preferred
- Working knowledge of Microsoft Outlook, Teams, Word, Excel, and PowerPoint
- Familiarity with the healthcare field, including Insurer, PBM, Specialty or Retail Pharmacy and Provider
- Understanding Managed Care and/or Retail Pharmacy operations with respect to Medicaid, Marketplace and /or Medicare
- Proficient in medical terminology, medication names, generics and biosimilars
- Application of Clinical guidelines, policies, and decision trees/tools
- Understanding the pharmacist’s clinical role in the care of members; utilization of Clinical expertise
- Strong written and verbal Communication skills, including use of proper grammar in print and e-mail communications
- Ability to simplify clinical language for lay persons
- Critical listening, thinking and problem-solving skills
- Attention to detail
- Organized and learns quickly
- Comfortable working in a fast-paced environment
- Time management skills
- Use of proper phone etiquette
- Ability to work independently and within a team environment
- Current, unrestricted Registered Pharmacist (RPh) licensure is required
- Ability to acquire additional State License(s) in multiple states, as required
- General office or Remote work environment; may be required to sit or stand for extended periods of time
Salary
Competencies
- Create an Inclusive Environment - Cultivate Partnerships - Develop Self and Others - Drive Execution - Influence Others - Pursue Personal Excellence - Understand the Business
FAQs
What is the last date for applying to the job?
The deadline to apply for Full-Time Pharmacist I - R7742 at CareSource is
28th of August 2024
. We consider jobs older than one month to have expired.
Which countries are accepted for this remote job?
This job accepts [
USA
] applicants. .