Managed Staffing, Inc.

Clinical Pharmacist Advisor Medicare

Managed Staffing, Inc. United States
Managed Staffing, Inc.

Clinical Pharmacist Advisor Medicare

Managed Staffing, Inc. United States
3 weeks ago 117 applicants

See who Managed Staffing, Inc. has hired for this role

Job Title: Remote Pharmacist - Medicare Part D

Location: Remote (All over USA)

Job Description

We are seeking an experienced and detail-oriented Pharmacist to join our remote team. The ideal candidate will have experience with Medicare Part D and prior authorizations. You will support Medicare Part D members and providers with their pharmacy benefit requests, ensuring cases are accurately set up, reviewing clinical information, performing provider outreach, and ensuring compliance with Medicare guidelines and timelines.

Responsibilities

  • Collaborate with multiple groups within Clinical Decision & Assessment (CD&A), answering clinical questions, collecting clinical/medical data for assessments, and performing reviews per health plan/employer criteria within service level agreements.
  • Coordinate timely communication of case decisions to physicians, health plans/employers, patients, and other healthcare professionals, following agreed-upon approval and denial management processes.
  • Review cases in progress and provide clinical decisions regarding prior authorizations, tier exceptions, and non-formulary requests.
  • Perform related projects and duties as assigned, including potential on-call and after-hours availability.

Qualifications

  • Licensure: Licensed Registered Pharmacist in the state of residence.
  • Experience: Minimum of 1 year of experience required, with 2-5 years preferred. Must have experience with Medicare Part D and prior authorizations.
  • Education: Bachelor's Degree required; Pharm D preferred.
  • Technical Skills: Knowledge of Access, PowerPoint, and Visio is preferable. Must be computer literate with proficiency in Excel and Word.

Training And Work Schedule

  • Initial Training: Attendance is crucial during the initial 8 weeks of training. New hires must be available Monday to Friday from 9am-5:30pm EST, with no vacation time planned. All time off must be discussed and disclosed during this initial review.
  • Regular Hours: 8am to 8pm EST/CST, 8 hours per day, Monday to Friday.
  • Rotating Weekends: 7am-3:30pm EST/CST on rotating weekends.

  • Seniority level

    Mid-Senior level

  • Employment type

    Contract

  • Job function

    Health Care Provider

  • Industries

    Hospitals and Health Care and Pharmaceutical Manufacturing

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