Pharmacist – RPh Operations Advisor – Specialty Medical Prior Authorization Aetna Position Available In [Unknown county], Rhode Island

Pharmacist

• RPh Operations Advisor
• Specialty Medical Prior Authorization Aetna#25-67090
  $53 per hour
  Remote, RI
  All On-site Job Description
  Our Client, a Retail Pharmacy company, is looking for a Pharmacist
• RPh Operations Advisor
• Specialty Medical Prior Authorization Aetna for their Remote location.

Responsibilities:

Collaborates with the Technicians and Nurses to process authorization requests, including answering clinical questions, collecting appropriate clinical/ medical data needed to perform clinical assessments, and reviews as per the health plan/employer agreed criteria within the designated service level agreements. (20%)
Coordinates timely communication of case decision to physician, health-plan/employer, patient and other healthcare professionals following agreed upon approval & denial management processes. (15%)
Handles inbound phone calls and escalations from physicians or patients regarding Prior Authorization (50%)
Establishes and maintains communication among Client, health plan and employer group staff. (5%)
Maintain professional and technical knowledge of drug and disease-states for the Specialty Medical programs administered within the Novologix. (5%)
Performs other related projects and duties as assigned including on call and after hours pharmacist availability could be required. (5%)

Requirements:

Minimum of 2-5 years of clinical experience with specialty medications or clinical review of prior authorization requests is preferred.
Experience using MS Office and other Windows based computer applications, strong organizational skills, interpersonal skills, and detail orientation are important for this position.
Active pharmacist license in state of residence in good standing
Bachelor’s degree in pharmacy or Pharm D. required with at least two years experience as a pharmacist.
Must have an active license in good standing. Why Should You Apply?
Health Benefits
Referral Program
Excellent growth and advancement opportunities As an equal opportunity employer, ICONMA provides an employment environment that supports and encourages the abilities of all persons without regard to race, color, religion, gender, sexual orientation, gender identity or express, ethnicity, national origin, age, disability status, political affiliation, genetics, marital status, protected veteran status, or any other characteristic protected by federal, state, or local laws.