Job Description

Job Description

Job Description

A-Line Staffing is now hiring a Fully Remote - RPh Operations Adviser - Specialty Medical Prior Authorization . This will be full time.

If you are interested in this Fully Remote - RPh Operations Adviser - Specialty Medical Prior Authorization Opportunity, please contact Michelle at 586-422-1171 or Mmansoor@alinestaffing.com.

Fully Remote - RPh Operations Adviser - Specialty Medical Prior Authorization Hours

• 40 hours per week
• Must be able to work any 8-hour shift from 7am to 10pm CST
• *Possible weekend shifts*

Fully Remote - RPh Operations Adviser - Specialty Medical Prior Authorization Compensation

• The pay for this position is $53.00 an hour paid bi-weekly
• Benefits are available to full-time employees after 90 days of employment
• A 401(k) with a company match is available for full-time employees with 1 year of service on our eligibility dates

Fully Remote - RPh Operations Adviser - Specialty Medical Prior Authorization Responsibilities

• Collaborating with 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.
• Coordinating timely communication of case decision to physician, health-plan/employer, patient and other healthcare professionals following agreed upon approval & denial management processes.
• Handling inbound phone calls and escalations from physicians or patients regarding Prior Authorization (50%)
• Establishing and maintaining communication among health plan and employer group staff.
• Maintaining professional and technical knowledge of drug and disease-states for the Specialty Medical programs administered within the Novologix platform.
• Performing other related projects and duties as assigned. On call and after hours pharmacist availability may be required.

Fully Remote - RPh Operations Adviser - Specialty Medical Prior Authorization Requirements

• Licensed Pharmacist in state of residence
• Experience with prior authorizations, MTM, specialty medications, or managed care companies

If you think Fully Remote - RPh Operations Adviser - Specialty Medical Prior Authorization Position is a good fit for you, please reach out to me - feel free to call, e-mail, or apply to this posting

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