Pharmacist - Medicare Part D
Pharmacist - Medicare Part D
Managed Staffing, Inc.
United States
See who Managed Staffing, Inc. has hired for this role
Job Title: Remote Pharmacist - Medicare Part D
Location: Remote
Job Description
We are seeking a detail-oriented and experienced Pharmacist to join our team remotely, providing direct support to Medicare Part D members and providers with their pharmacy benefit requests. This role involves accurately setting up cases, reviewing clinical information, performing provider outreach, and ensuring compliance with Medicare guidelines and timelines. This position offers an excellent opportunity to begin a career with a leading healthcare company, emphasizing timely and accurate documentation and best-in-class service experiences.
Key Responsibilities
Clinical Support and Data Collection (20%)
Location: Remote
Job Description
We are seeking a detail-oriented and experienced Pharmacist to join our team remotely, providing direct support to Medicare Part D members and providers with their pharmacy benefit requests. This role involves accurately setting up cases, reviewing clinical information, performing provider outreach, and ensuring compliance with Medicare guidelines and timelines. This position offers an excellent opportunity to begin a career with a leading healthcare company, emphasizing timely and accurate documentation and best-in-class service experiences.
Key Responsibilities
Clinical Support and Data Collection (20%)
- Collaborate with multiple groups within Clinical Decision & Assessment (CD&A).
- Answer clinical questions and collect necessary clinical/medical data for assessments.
- Perform reviews as per health plan/employer criteria within designated service level agreements.
- Coordinate timely communication of case decisions to physicians, health plans/employers, patients, and other healthcare professionals.
- Follow agreed-upon approval and denial management processes.
- Review cases in progress and provide clinical decisions regarding prior authorizations, tier exceptions, and non-formulary requests.
- Perform related projects and duties as assigned, including potential on-call and after-hours availability.
- Licensure: Licensed Registered Pharmacist in the state of residence.
- Experience: Minimum of 1 year of experience required, although 2-5 years is preferred.
- Education: Bachelor's Degree required; Pharm D preferred.
- Technical Skills: Knowledge of Access, PowerPoint, and Visio is preferable. Must be computer literate with proficiency in Excel and Word.
- Initial Training: Attendance is crucial during the initial 8 weeks of training. New hires must be available Monday to Friday from 9 am-5:30 pm EST,
- Regular Hours: 8 am to 8 pm EST/CST, 8 hours per day, Monday to Friday.
- Rotating Weekends: 7 am-3:30 pm EST/CST on rotating weekends.
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Seniority level
Mid-Senior level -
Employment type
Contract -
Job function
Health Care Provider -
Industries
Mental Health Care, Hospitals and Health Care, and Pharmaceutical Manufacturing
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