Prior Authorization Pharmacist

Company Description

HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!

Job Description

Pharmacist will be responsible for supporting the Prior Authorization program as well as other clinical services through the Clinical Call Center. This role will provide daily operational support to the PA department and Clinical Call Center and will serve as clinical resources for both internal and external Catamaran/United customers in regards to the PA program and other clinical call center activities.

Serve as a clinical resource to the PA staff in reviewing denied, unclear or questionable PA requests. Communicate PA/appeal requirements to healthcare providers as requested.

• Assist the PA managers and supervisors in the daily operations of the PA department including the planning and implementation of new client PA programs. Educate PA staff on client or Catamaran specific PA guidelines and processes.

• Assist in administering PA appeal services including first level appeal reviews and coordination of 2nd level appeals with the appeal vendor.

• Handle any escalated calls and other issues that may arise in the clinical call center to help maintain a smooth workflow and ensure turnaround times/SLAs are met for each client.

• Assist in training activities for internal/external candidates entering the clinical call center

• Other activities as determined by the PA Manager

Qualifications

• Must have clear and active Pharmacist license in IL throughout the assignment

• Must come from a specialty or retail pharmacy setting, although new grads are also fine to submit

• Must be very detailed oriented and able to multi-task and navigate through various screens

• Must be proficient with computer and able to use and learn systems quickly

• Excellent verbal and written communication skills

• Strong customer service and commitment to professionalism

• Strong typing skills

Additional Information

Position Introduction:

Are you a Pharmacy Technician in Lisle area looking for a new opportunity with a prestigious healthcare company? Do you want the chance to advance your career by joining a Fortune 500 company that provides on-going training and development? Are you interested in working for a company that offers benefits for full-time permanent employees, flex schedules and the opportunity to grow with the company? If you answered “yes” to any of these questions – this is the position for you!

Want More Information?

Interested in hearing more about this great opportunity? Reach out to Hannah Barreta at 321-710- 4797 for immediate consideration.