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Responsibilities
- Complete prior authorization reviews for all lines of businesses
- Respond to escalations from internal departments
- Apply clinical judgment for medication policies and coverage determinations
- Organize and prioritize requests for timely case management
- Build and adjust authorizations within the claim adjudication system
- Triage and respond to inquiries regarding claims processing
- Maintain communication with other functional areas within SmithRx
- Communicate SmithRx’s vision, mission, values, and goals
Requirements
- Bachelor’s Degree in Pharmacy or PharmD required
- 2-5 years of pharmacy experience
- Active pharmacist license
- 1 year of prior authorization experience preferred
- Strong clinical skills and problem-solving ability
- Proficiency in drug literature and clinical trial evaluation
- Proficiency in MS Word, Excel, and PowerPoint preferred
Benefits
- Seasonal contract role with 6-month duration
- Opportunity for conversion to full-time based on performance
- Laptop provided for the work assignment
- Competitive benefits through staffing vendor
