Clinical Review Pharmacist (Seasonal) - Remote

Overview

The Clinical Review Pharmacist will join SmithRx's clinical services team to optimize clinical offerings and outcomes for customers, members, and clients.

In Short

• Complete prior authorization reviews for all lines of businesses and edit types.
• Respond to escalations from internal departments.
• Apply clinical judgment for coverage determinations.
• Organize and prioritize requests for timely case management.
• Build and adjust authorizations within the claim adjudication system.
• Triage inquiries regarding claims processing and prior authorization requests.
• Maintain communication with other functional areas.
• Communicate SmithRx's vision, mission, values, and goals effectively.

Requirements

• Bachelor’s Degree in Pharmacy or PharmD required.
• 2-5 years pharmacy experience.
• Clear, active pharmacist license.
• Preferred: 1 year experience with prior authorizations.
• Strong clinical skills and sound clinical judgment.
• Proficiency in drug literature and clinical trial evaluation.
• Emphasis on problem-solving skills.
• Proficiency in MS Word, Excel, and PowerPoint preferred.

Benefits

• Competitive benefits through staffing vendor.
• Opportunity for conversion to full-time based on performance.
• Receive a laptop for work assignment.