- Pay: $53 per hour + Health Benefits after 90 days!
- 100% Remote - Work from Home - anywhere in USA
- Full-Time/40 hours per week - 2 shift options: Monday-Friday (no weekends), must be flexible to work any 8-hour shift between 7AM to 8PM CST or // Monday-Friday + rotating weekends 8AM - 5PM EST
- Receives prior auth requests in remote setting, interprets clinical guideline/s criteria, and makes coverage determination on prior authorization cases.
- Coordinates timely communication of case decision to physician, health-plan/employer, patient and other healthcare professionals following agreed upon approval & denial management processes.
- Establishes and maintains communication among, health plan and employer group staff.
- Pharmacist license from ANY state in US - license is required to be from the same state as candidate's location
- Experience in PBM or managed care environment REQUIRED -- will NOT accept Prior Authorization experience from retail/dispensing pharmacy settings
- Prior authorization experience highly preferred, but will consider any PBM/Managed Care experience
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