Healthcare

Hire the right healthcare staff with speed and precision locally or nationwide.

Learn More

How to Cost-Effectively Build a Nursing Staff in an Age of Travel Nursing

Uncover alternative and sustainable staffing solutions to address nursing shortages

Read the article

Life Sciences

Hire skilled life sciences talent by partnering with a nationwide recruitment agency with local market expertise.

Current Trends in the Life Sciences Job Market

Learn how partnering with a staffing agency is a powerful way to combat the challenges of hiring in the current life sciences job market

Read the article

Technology

Execute critical healthcare IT initiatives with increased flexibility and cost-effectiveness with us at your side.

The Technology Hiring Outlook: What We're Seeing Right Now

Uncover how to handle an employee-led technology market.

read the article

For JobSeekers

Match your unique skills with in-demand jobs at growing organizations.

Learn More

Resource Center

Explore our library of insights and tips designed to help healthcare leaders and job candidates align.

Explore resources

About Us

We’re positively impacting lives as a leading provider of workforce solutions for clients and talent.

Learn More

Back to jobs

Remote Pharmacist

Posted: September 18, 2024
Salary:Up to US$60.00 per hour
Location:Tempe
Job type: Contract
Discipline:Allied
Reference:233956_1726704323
Work Location:On-site

Job description

Job Summary:

We're a fully licensed health insurer. Our goal is to make healthcare simple, transparent, and human. We are changing how health insurance works by creating a healthcare experience that's intuitive and puts people, not cost or workflows, first. And we're using a consumer-focused and tech-driven approach to do so. This positions us uniquely in the space - and creates one of the biggest opportunities in healthcare.

In this role, you will play an essential role in building our pharmacy utilization management function. The Clinical Review team is one of most important clinical functions - we encourage evidence-based practice through utilization review to ensure our members get access to the right care - particularly those who need it most. You will be responsible for understanding and helping to grow our pharmacy utilization management program and driving high quality reviews.

Responsibilities:

  • Completing review and rendering decisions on authorizations and appeals for specialty, non-specialty, and physician administered drugs
  • Conducting peer-to-peers with prescribers to discuss the clinical rationale of adverse determinations
  • Participating in clinical quality audits (inter-rater reliability testing)
  • Providing internal team support for escalations and questions from pharmacy technicians and physicians
  • Developing and reviewing clinical criteria

Experience Required:

  • Must have 2+ years working in PBM or health insurance company doing prior auths or appeals
  • We're looking for someone with 3+ years of experience in managed care performing clinical review/utilization management. Must-have qualifications and expertise include:
  • Active, unrestricted pharmacy license
  • Doctor of Pharmacy Degree
  • Willingness to obtain licensure/training with new states, as needed
  • Acute attention to detail and excellent written and verbal communication skills
  • Strong clinical skills and experience applying clinical criteria in clinical review setting
  • Ability to obtain and maintain secure, high-speed and consistent internet connectivity

Benefits:

Minimum Essential Coverage (MEC) plan

  • Two different fixed indemnity plan add-ons
  • Major Medical Plans, including 1 HSA Plan
  • Dental
  • Vision
  • Short-term disability
  • Life and AD&D

Hours: 4 - 10 hour shifts (8 or 10 hour shifts between 7am - 5:30 pm CST)

**1 Weekend day each week required after training and nest period are complete**

Training Hours: M-F 8am - 5pm CST (4 weeks) / 2 week nesting period

Location: (100% Remote)

Educations/Certification Requirements::

Pharmacist License Active/ Doctor of Pharmacy Degree

Pay: $60/hr