Biotech and Pharmaceutical, Centers for Medicare and Medicaid Services (CMS), Clinical Information, Communication Skills, Detail Oriented, Documentation, Environmental Health, Healthcare, Managed Care, Medicare, Pharmacy, Presentation/Verbal Skills, Problem Solving Skills, Quality Metrics, Request for Information (RFI), Time Management, Writing Skills
LOCATION
Phoenix, AZ
POSTED
4 days ago
Job Title: Pharmacist
Job Duration:12+ Months (Possibilities of extension)
Shift: Business Hours are 7am - 8pm EST Monday - Friday and 7am - 4:30pm EST Sat and Sunday. Set Rotation.
Job Location: Phoenix, AZ 85001
Position Summary:
As a Clinical Pharmacist Advisor, Medicare B Operations, you will support Medicare Part B members, prescribers, and providers by processing coverage-related requests for injectable and infused medications covered under their medical benefits.
You will be responsible for accurate case set up, review of clinical information for decisioning the request, performing outreach to providers for more information when needed, and ensuring accurate decisions that comply with compendia and Medicare guidelines, CMS-mandated timelines, and internal quality standards.
You will demonstrate strong attention to detail, professional verbal and written communication skills, and the ability to problem-solve in a highly regulated, fast-paced environment.
This is a great opportunity to initiate a career with a leading healthcare company by reviewing information and completing timely and accurate documentation of Medicare Part B requests, in compliance with Medicare guidelines, while promoting a best-in-class service experience.
This position is full-time, remote, non-exempt, and requires schedule flexibility based on business needs.
Experience:
Previous experience in managed care, PBM environment, institutional healthcare, pharmacy, or related experience (preferred).
Education:
Bachelor's degree in pharmacy or Pharm D. required. Must have an active license in good standing in state of residence.