State Licensed Appeals Pharmacist

Job Summary

A company is looking for an Appeals Pharmacist (Remote).

Key Responsibilities

• Evaluate prior authorization appeals for drug appropriateness per policy criteria and client guidelines
• Provide excellent customer service to health plan clients, practitioners, and members
• Serve as an educational resource regarding drug and clinical information for all internal and external customers

Required Qualifications, Training, and Education

• Minimum of one year of experience working as a pharmacist
• PharmD degree and a pharmacist license in good standing
• Experience with commercial and Medicare Part D appeals is strongly preferred
• Ability to work in a fast-paced environment and manage multiple priorities
• Strong working knowledge of medical insurance terminology and processes