Clinical Pharmacist

The purpose of this position is to process requests for insurance coverage of formulary and non-formulary drugs that reject at the dispensing pharmacy based on pre-determined plan criteria. 

Daily Responsibilities:  

• Review Prior Authorization cases and render coverage determination based on clinical criteria and plan design in a fast paced environment 

• Consulting physicians/providers with questions and interpretations of clinical guideline criteria and coverage determinations that have been rendered

• Participate in quality improvement and process enhancement projects

• Maintain productive working relationships with team members, other internal and external customers, etc.