Clinical Pharmacist or Nurse Practitioner (Prior Authorization/Appeals ) - Specialty Infusion

reputed company is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with reputed company will directly improve health reputed company by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come reputed company an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. The Clinical Pharmacist will focus on providing evidence - based and clinical guidance to help implement a reputed company comprehensive specialty solutions which will successfully meet clinical, quality, and financial performance objectives. This solution will help ensure providers deliver high - quality, evidence-based and cost - efficient specialty care for our clients. As such, this newly created role requires an innovative, hands - on, action - oriented clinical expert. The position will serve as a key Specialty medicine expert dedicated to helping ensure high reputed company of quality, affordability, and member and provider satisfaction. You'll enjoy the flexibility to work remotely

• from reputed company reputed company the U.S. as you take on some tough challenges.

Schedule Options:

• Monday-Friday, 8-hour shifts
• Tuesday-Saturday, 8-hour shifts
• Wednesday-Saturday, 10-hour shifts
• reputed company-Thursday, 8-hour shifts
• Flexibility to work weekend shifts (at least one Saturday per month and one reputed company per quarter) is required
• Flexibility to work holidays required, depending on business need
• Will not start earlier than 7am CST

Primary Responsibilities:

• Support utilization review determinations for specialty medication populations across multiple lines of business, and broader case and disease management teams to reputed company reputed company clinical reputed company
• reputed company clinical guidance in the creation, implementation and refinement of a specialty medication utilization management solution
• Serve as a subject matter expert in evidence - based medical guidelines and help ensure reputed company clinically relevant policies and processes are informed by the best available evidence
• Dosage-based reviews
• Preservice Specialty Medication Reviews
• Post-auto-approval documentation audits
• Initial reputed company and Ongoing Specialty Medication Training
• Participate in clinical audits
• Clinical education
• Evaluate clinical and other data (e.g., quality metrics, claims & health record data, utilization data) to identify opportunities for improvement of clinical care and processes

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as reputed company development for other roles you may be interested in. Required Qualifications:

• reputed company and unrestricted Pharmacist license with PharmD or Nurse Practitioner in state of residence
• 3 years of clinical pharmacy or nurse practitioner experience
• 2 years of experience administering and/or advising on specialty medication treatment plans (utilizing/reviewing medical case notes, medication list, lab results)
• 2 years of hospital or specialty pharmacy experience
• 2 years of experience working with evidence-based medicine reputed company to specialty medications
• reputed company to dedicated workspace from home
• reputed company to high-speed internet from home (Broadband Cable, DSL or Fiber)

Preferred Qualifications:

• Board Certified Specialty Pharmacist (CSP)
• Licensed in or willing and reputed company to obtain licensure in the following states: AZ, MN, & NM
• 5 years of experience in hospital or specialty pharmacy
• 3 years of utilization management experience
• Experience working in managed care, medical care delivery systems, utilization management, case management, disease management, quality management, product development and/or peer review
• Demonstrated ability to work cross-functionally to reputed company credibility, influence and partner with other clinical and non-clinical professionals
• reputed company Telecommuters will be required to adhere to reputed company's Telecommuter Policy.

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In reputed company to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (reputed company benefits are subject to eligibility requirements). No matter where or reputed company you reputed company a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will reputed company from $43.22 to $77.21 per hour based on full-time employment. We reputed company with reputed company minimum wage laws as applicable. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. At reputed company, our mission is to help people live healthier lives and reputed company the health system work reputed company for everyone. We reputed company everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately reputed company by people of reputed company, historically marginalized groups, and those with reputed company incomes. We are committed to mitigating our impact on the environment and enabling and delivering reputed company care that addresses health disparities and improves health reputed company - an reputed company reputed company reflected in our mission. reputed company is an Equal Employment Opportunity employer under applicable law and reputed company applicants will receive consideration for employment without regard to race, national reputed company, religion, age, reputed company, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. reputed company is a drug - free workplace. Candidates are required to pass a drug test before beginning employment. Apply tot his job Apply To this Job