Job Description:
This position is responsible for reviewing and completing criteria based prior authorizations as per policy and procedure.
Responsibilities:
- Conducted coverage determinations and prior authorizations for prescription drugs, evaluating them against established workers compensation criteria, guidelines, and relevant literature.
- Reviewed worker's compensation claims data for clinical appropriateness, cost efficiency, and therapeutic benefit.
- Provided evidence-based recommendations to prescribers, utilizing various state-specific workers compensation guidelines to ensure appropriate utilization and minimize costs.
- Monitored drug utilization patterns, identified opportunities for cost containment, and implemented initiatives to optimize drug therapy outcomes for workers compensation patients.
- Will be responsible for Reviewing and completing criteria based on prior authorization as per policy and procedure.
Experience:
Prior Authorization Experience Is Required.
PBM Experience is required.
Appropriate state license required.
Basic Computer Skills Required.
Strong organizational skills, interpersonal skills, and detail orientation are important for this position.
Skills:
Prior Authorization
Pharmacy Benefit Management
Medicare Part D
Education:
High School Diploma or GED required.
Bachelor's degree in pharmacy or Pharm D. also required with at least two years’ experience as a pharmacist.
Must have an active license in the state of residence in good standing.
About US Tech Solutions:
US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions. To know more about US Tech Solutions, please visit www.ustechsolutions.com.
US Tech Solutions is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, colour, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.