Job Description
Job Title: Pharmacist
Job Description
As a Pharmacist, you will be responsible for reviewing Medicaid members’ Utilization Management requests, including formulary exceptions, prior authorization, step therapy, and quantity limit exceptions. You will apply clinical judgment and communicate effectively with providers to determine the approval or denial of prior authorizations based on client-specific criteria. This role requires attention to detail and regular communication with providers and team members.
Responsibilities
+ Review and process Medicaid members’ Utilization Management requests.
+ Apply clinical judgment to determine authorization approvals or denials.
+ Engage in regular communication with providers.
+ Participate in monthly video calls with supervisors.
+ Collaborate with coworkers, technicians, and High level pharmacists throughout the day.
Essential Skills
+ Doctor of Pharmacy (PharmD) or Bachelor...
Job Description
As a Pharmacist, you will be responsible for reviewing Medicaid members’ Utilization Management requests, including formulary exceptions, prior authorization, step therapy, and quantity limit exceptions. You will apply clinical judgment and communicate effectively with providers to determine the approval or denial of prior authorizations based on client-specific criteria. This role requires attention to detail and regular communication with providers and team members.
Responsibilities
+ Review and process Medicaid members’ Utilization Management requests.
+ Apply clinical judgment to determine authorization approvals or denials.
+ Engage in regular communication with providers.
+ Participate in monthly video calls with supervisors.
+ Collaborate with coworkers, technicians, and High level pharmacists throughout the day.
Essential Skills
+ Doctor of Pharmacy (PharmD) or Bachelor...
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