Job Description

We are seeking a Clinical Pharmacist to join our Prior Authorization team. As a Clinical Pharmacist, you will play a critical role in reviewing prior authorization cases and making coverage determinations based on clinical criteria and plan design. This is a remote position that requires strong computer skills, excellent communication abilities, and the capacity to work in a fast-paced environment.

You must reside in the Central Time Zone for this opportunity

Primary Responsibilities:

• Review and process prior authorization cases, ensuring accurate data entry and updating as necessary
• Receive and respond to phone calls from pharmacy technicians and providers, gathering clinical information and rendering coverage determinations
• Consult with physicians and providers to interpret clinical guidelines and make coverage decisions
• Advise on appropriate formulary alternatives and provide medication guidance to pharmacy technicians and physicians
• Gather complex clinical information, apply coverage policies and criteria, and work within regulatory guidelines to make coverage determinations
• Prioritize workload, manage assignments, and utilize resources efficiently while meeting department standards
• Ensure compliance with state and federal pharmacy laws and regulations
• Support quality assurance and improvement initiatives
• Build strong relationships with coworkers, internal customers, and other departments through excellent customer service and a positive image
• Demonstrate ability to maintain productive working relationships with team members, internal and external customers, and management team

Requirements:

• Bachelor's or Doctorate of Pharmacy degree
• Active State Pharmacist License
• Excellent computer skills, including proficiency with mouse and keyboard, and ability to navigate multiple systems and screens
• Secure home workspace with reliable internet access (hard-wired Ethernet cord preferred)
• Excellent attendance and availability to work a flexible schedule, including overtime and holidays

Working Conditions:

• 4-week training program, Monday-Friday, 8:00am-5:00pm (subject to change)
• 8-hour shifts with 1-hour lunch break, varying start times between 5:00am and midnight
• 5-day workweek, including possible weekend days
• Scheduled overtime and holiday work may be required
• Home internet access and secure workspace required

Equity Staffing Group is one of the fastest growing Native American owned staffing companies in the United States. We are a certified Minority Business Enterprise (MBE) by the National Minority Supplier Development Council (NMSDC) and the Rocky Mountain Minority Supplier Development Council (RMMSDC).

Equity Staffing Group is an Equal Employment Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other characteristic protected by law. Equity Staffing Group will consider qualified applicants with criminal histories in a manner consistent with the requirements of applicable law.

We welcome you to learn more about our company by visiting .

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