Tennessee Licensed Clinical Pharmacy Specialist

Job Summary

Supporting Medicare and D-SNP coverage review activities, the full-time Tennessee Licensed Clinical Pharmacy Specialist will manage case reviews, collaborate with healthcare providers, and ensure timely access to pharmacy benefits in a remote environment.

Key responsibilities

• Enter authorizations and test claims into the pharmacy benefit system for accurate claim adjudication
• Handle communications with providers and members to assist in coverage determinations and appeals
• Review daily pharmacy reports and assist with departmental audits and quality improvement activities

Required qualifications

• High School Diploma or equivalent
• 2 years of pharmacy experience required
• National Certification as Pharmacy Technician (PTCB)
• Proficiency in Microsoft Office (Outlook, Word, Excel, PowerPoint)
• Knowledge of medical/pharmacy terminology