Job Description

Pharmacist
We are seeking a licensed Pharmacist to join our Utilization Management team. In this role, you will apply your clinical expertise to complete a variety of utilization review functions, including prior authorizations, coverage exceptions, quantity limit exceptions, and more. You will work independently while collaborating closely with a team of pharmacists and pharmacy professionals.
Quality and performance are tracked through monthly productivity and accuracy goals.
Responsibilities

+ Perform clinical utilization management reviews (PAs, CEs, QLs, etc.)

+ Make independent, clinically sound decisions based on established guidelines

+ Work efficiently to meet quality and productivity benchmarks

+ Navigate multiple systems and tools to complete case documentation

+ Collaborate with pharmacy team members as needed for clarification or escalations

+ Maintain compliance with all regulatory and licensing requirements

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