SmithRx is hiring a
Clinical Review Pharmacist

closed
Logo of SmithRx

SmithRx

πŸ’΅ ~$194k-$284k
πŸ“Remote - Worldwide

Summary

Join the clinical services team at SmithRx as a Clinical Review Pharmacist to optimize clinical offerings and outcomes for customers, members, and clients. This is a seasonal contract position with a 6-month contract length, offering opportunities for conversion to full-time based on performance and business need.

Requirements

  • Bachelor’s Degree in Pharmacy or PharmD required
  • 2-5 years pharmacy experience
  • Clear, active pharmacist license

Responsibilities

  • Complete prior authorization reviews for all lines of businesses and all edit types
  • Responds to escalations from other internal departments
  • Apply clinical judgment to evaluate member clinical situation against medication policies and plan benefit design to make coverage determinations for approval or denial, including identification of covered alternatives
  • Organize and prioritize multiple requests internally and externally to ensure timely prior authorization case management
  • Build and adjust authorizations under protocol within the claim adjudication system
  • Triage, assess and respond to pharmacy technicians, member support, account management, benefit/plan operations and document management specialist inquiries regarding claims processing and prior authorization requests
  • Maintain open lines of communication with other functional areas within SmithRx
  • Provide effective communication of SmithRx’s vision, mission, values and goals

Preferred Qualifications

  • 1 year experience with prior authorizations for commercial plans
  • Strong clinical skills with the ability to apply sound clinical judgment to a variety of complex situations
  • Proficiency in drug literature and clinical trial evaluation, including electronic databases such as Micromedex, Medline, and UptoDate
  • Emphasis on problem solving skills, including identifying and accepting a challenging situation and proposing a solution
  • Proficiency in MS Word, Excel, and Powerpoint including tables, charts and figures preferred
This job is filled or no longer available

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