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 assignedSkills: 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 neededPreferred• 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