Prior Authorization Pharmacist Trainer - Remote

Overview

We are seeking a dynamic and experienced pharmacist trainer to join our team. As a pharmacist Trainer, you will play a pivotal role in developing and delivering training programs that enhance knowledge, operational efficiency, and customer service skills to our pharmacist staff. The successful candidate will have a strong background in pharmacy practice, a passion for education and the ability to create engaging and impactful training content.

In Short

• Facilitate the onboarding process for new hires and provide comprehensive training sessions for pharmacists on prior authorization systems, processes, and procedures utilizing a variety of training methods.
• Develop and update training materials, resources, verbiage templates, job aids, and communicate updates to the team.
• Ensure that training content is accurate, up-to-date, clinically relevant, compliant with federal and state regulations, and internal policies.
• Maintain detailed records of training sessions, participant attendance, and training materials for auditing and reporting purposes.
• Assess performance of pharmacists through evaluations, quizzes, and practical assessment to identify areas for improvement and provide constructive feedback.
• Collaborate with pharmacy managers, supervisors, and other relevant stakeholders to identify training needs, performance gaps and ensure alignment with company goals.
• Make clinical prior authorization and appeals determinations in accordance with medical necessity and covered benefit guidelines within established turnaround times.
• Provide detailed and thorough documentation in prior authorization cases, overrides and call center cases.
• Perform peer-to-peer reviews with providers when requested.
• Perform scientific literature evaluation using primary, secondary, and tertiary drug resources to support decision-making and recommendations to providers.

Requirements

• A Doctor of Pharmacy (Pharm.D.) degree or Bachelor of Pharmacy degree from an accredited pharmacy program.
• An active unrestrictive pharmacist license.
• 3+ years of experience as a clinical pharmacist in Pharmacy Benefit Management (PBM) setting.
• Previous experience developing and delivering training programs.
• Solid understanding of prior authorization operations, Federal and State laws, and regulations.
• Excellent written communication and presentation skills to effectively convey complex information to diverse audiences.
• Excellent analytical skills and attention to detail.
• Ability to collaborate effectively with cross-functional teams and adapt to changing priorities.
• Proficiency in using e-learning platforms, multimedia tools, and Microsoft Office Suite.
• Ability to work a flexible schedule independently with minimal supervision, staying productive in a remote, high-volume, and metric driven call center environment.

Benefits

• Flexible work environment.
• Opportunity to make a significant impact in healthcare.
• Collaborative team culture.
• Professional development opportunities.
• Competitive salary and benefits package.