Tennessee Licensed Clinical Pharmacy Specialist
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Job Summary
Supporting Commercial and Exchange coverage review activities, the full-time Tennessee Licensed Clinical Pharmacy Specialist will manage cases, 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 proper claim adjudication
- Assist providers and members with coverage determinations and appeals through phone and email communications
- Review daily pharmacy reports and participate in 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)
- Experience with Medicare, Medicaid, retail pharmacy, or managed care settings preferred
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