You are applying for a position through Medix, a staffing agency. The actual posting represents a position at one of our clients.

Job Summary

Our client is seeking a skilled Pharmacist to review and render decisions on prior authorization requests for drugs under the pharmacy benefit. This role requires conducting peer-to-peer calls with prescribers, participating in clinical quality audits, and providing internal support.

Key Responsibilities

• Review and render decisions on prior authorization requests for drugs under the pharmacy benefit.
• Conduct peer-to-peer calls with prescribers to discuss clinical rationale of adverse determinations.
• Participate in clinical quality audits and inter-rater reliability testing.
• Provide support to internal teams for escalations and questions from the pharmacy team.
• Apply clinical expertise to ensure appropriate and safe use of pharmaceuticals.
• Compliance with all applicable laws and regulations.
• Other duties as assigned.

Qualifications

• Doctor of Pharmacy Degree.
• Active, unrestricted pharmacist license.
• 3+ years of experience as a licensed pharmacist.
• Willingness to obtain licensure/training with new states, as needed.
• 1+ years of experience in clinical review in a managed care setting preferred.
• Strong clinical skills and experience in a clinical review setting preferred.
• Board Certification (e.g., BCPS, BCOP) preferred.
• Residency training preferred.

Experience

• 3+ years of experience as a licensed pharmacist.

Skills

• Strong clinical skills and experience applying clinical criteria in clinical review setting.
• Excellent communication skills for conducting peer-to-peer calls.

Additional Requirements

• At least one weekend shift per week, such as every Saturday or every Sunday.
• Potential schedule options include four 10-hour shifts or five 8-hour shifts.

Benefits

• Paid Sick Leave (Medix provides paid sick leave according to state and local sick leave ordinances).
• Health Benefits / Dental / Vision (Medix offers 6 different health plans: 3 Major Medical Plans, 2 Fixed Indemnity Plans (Standard and Preferred), and 1 Minimum Essential Coverage (MEC) Plan. Eligibility for health benefits is based on verifying that an average of 30 hours per week during the first 4 weeks of the work assignment has been met. If you meet eligibility requirements and take action to enroll, you will be covered no earlier than 60 days into your assignment, depending on plan selection(s)).
• 401k (Eligible on the first 401k open enrollment date following 6 consecutive months on assignment. 401k Open Enrollment dates are 1/1, 4/1, 7/1, and 10/1).
• Short Term Disability Insurance.
• Term Life Insurance Plan.

^*We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state, and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO), and the California Fair Chance Act (CFCA).

Medix Overview:

With over 20 years of experience connecting organizations with highly qualified professionals, Medix is a leading provider of workforce solutions for clients and candidates across the healthcare, scientific, technology, and government industries. Through our core purpose of positively impacting lives, we’re dedicated to creating opportunities for job seekers at some of the nation's top companies. As an award-winning career partner, Medix is committed to helping talent find fulfilling and meaningful work because our mission is to help you achieve yours.

^*As a job position within our Insurance division, a successful completion of a background check may be required as a condition of employment. This requirement is directly related to essential job functions including but not limited to: accessing medical and confidential records, verifying financial information, and working within departments that care for vulnerable populations, such as, minors, elderly and those with physical or mental disabilities. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients