Remote Pharmacist - 256186

Responsibilities: • Review and render decisions on prior authorizations requests for drugs under the pharmacy benefit • Conduct peer-to-peer calls with prescribers to discuss the clinical rationale of adverse determinations • Participate in clinical quality audits and inter-rater reliability testing • Provide support to internal teams for escalations and questions from the pharmacy team • Apply clinical expertise to ensure appropriate and safe use of pharmaceuticals by members and providers • Compliance with all applicable laws and regulations • Other duties as assigned Skills: Required • Doctor of Pharmacy Degree • Active, unrestricted pharmacist license • 3+ years of experience as a licensed pharmacist • Willingness to obtain licensure/training with new states, as needed Preferred • 1+ years of experience performing clinical review in a managed care setting and/or experience writing clinical criteria • Strong clinical skills and experience applying clinical criteria in clinical review setting • Board Certification (i.e. BCPS, BCOP) • Residency training