Tennessee Licensed Clinical Pharmacy Specialist
Job Summary
Supporting Commercial and Exchange coverage review activities, the full-time remote Tennessee Licensed Clinical Pharmacy Specialist will manage cases, engage with healthcare providers, and contribute to coverage determinations that enhance member care and health outcomes.
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 completing 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)
- Proficient in Microsoft Office (Outlook, Word, Excel, and PowerPoint)
- Knowledge in medical/pharmacy terminology
Complete Job Description
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