Job Summary
A healthcare company is searching for a person to fill their position for a Telecommute Coverage Review Pharmacist in the Nashville Area.
Core Responsibilities Include:
- Performing prospective and retrospective coverage reviews and appeals per State and Federal regulations
- Building and maintaining decision trees in the prior authorization system
- Ensuring that decision letters meet regulatory compliance
Qualifications for this position include:
- Solid understanding of regulatory guidelines (CMS, FDA, NCQA, EQRO) required
- Doctor of Pharmacy (PharmD) degree required
- 3 years' clinical experience required
- completion of 1 year residency and/or board certification
- Licensed in Tennessee to practice pharmacy, or eligible for licensure in the state of Tennessee to practice pharmacy
- Proficient in Microsoft Office (Outlook, Word, Excel and PowerPoint)
