Immediate need for a talented Clinical Pharmacist. This is a 05+ months contract opportunity with long-term potential and is located in NC(Remote). Job ID: 26-21713 Pay Range: $50/hr - $58/hour. Employee benefits include, but are not limited to, health insurance (medical, dental, vision), 401(k) plan, and paid sick leave (depending on work location). Key Responsibilities: Shift/Work Schedule : M-F 8-5 EST Review prior authorization requests and make determinations for drug products according to member benefits and coverage criteria Report to utilization review statistics to corporate compliance committees Review data and summarize daily utilization review numbers Responsible for tracking compliance of review cases Provide clinical guidance and support to the assigned pharmacy technicians Knowledge of drug coding (NDC, GCN, GPI and USC) and NCPDP claims adjudication systems Review guideline criteria for prior authorization and non-formulary drugs in support of Pharmacy and Therapeutics Committee function and pharmacy benefit design. Ensure and evaluate quality controls and implement opportunities for performance improvement in pharmacy practices Research drug information to maintain drug knowledge and disease state understanding for application to prior authorization reviews Key Requirements and Technology Experience: Bachelor's degree or advanced degree 3+ years of experience in related field. Top 3-4 Required Skills: Able to work on computers and has work from home experience. High volume call Medicare and Medicaid experience Health Plan Managed care experience MTM/CMR Years of Experience: 3-5 Education/Certifications Required: Pharmacist license for the state. Pharm D is preferred Industry Specific Experience – required, ideal, necessary? Retail, HMO, DSNIP Breakdown of Duties/Typical Day: Participating in comprehensive medication review. Cold calling members and reaching out on non adherence. Advocate for member on adherence gaps. Time that you will be on the phone is going to be 3.5 to 4.5 hours a day Our client is a leading Health Insurance Industry, and we are currently interviewing to fill this and other similar contract positions. Pyramid Consulting, Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. #J-18808-Ljbffr
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