Adecco Healthcare & Life Sciences is hiring an Appeals Pharmacist. This role is remote / work from home. Please read below and apply with an updated resume for consideration.
Please note you must have a California Pharmacist license to qualify.
Type: Six-month contract, possibility for extension or fulltime offer
Schedule: Monday through Friday, 8am to 5pm PST
Pay: $70.00 to $73.00 an hour
Responsibilities of the Appeals Pharmacist:
· Collaborates with the coordinators and nurses to process referrals, including answering clinical questions and collecting appropriate clinical/medical data needed to perform clinical assessments and reviews as per the health plan/employer-agreed criteria within the designated service level agreements.
· Evaluate and review all prior authorization requests and render coverage determinations based on clinical criteria and plan design.
· Includes verifying insurance coverage and eligibility, interpreting clinical guideline criteria, consulting physicians and other healthcare providers, and appropriately utilizing clinical knowledge and resources while complying with department protocols.
· One of the crucial responsibilities is to guarantee that the decisions regarding cases are conveyed promptly and efficiently to all the healthcare providers, health plans/employers, patients, and other healthcare professionals following agreed-upon approval & denial management processes.
· Performs and handles inbound and outbound phone calls with coordinators, nurse, physicians, healthcare providers, and/or patients to facilitate prior authorization requests, answer inquiries, and/or resolve escalations.
· Performs other related projects and duties as assigned, including attending training sessions and development meetings, and providing on-call and after-hours pharmacist availability as needed.
Qualifications of the Pharmacist:
· Pharm D
· Active and unrestricted Pharmacist license in state of California
· 2 years of experience working as a prior authorization pharmacist
· Experience using clinical resources, e.g., Micromedex, Lexicomp, Clinical Pharmacology, Up to Date
Why work for Adecco?
Weekly Pay on Friday
401(k) Plan
Skills Training
Excellent medical, dental, and vision benefits
Benefit offerings include medical, dental, vision, life insurance, short-term disability, additional voluntary benefits, EAP program, commuter benefits and 401K plan. Our program provides employees the flexibility to choose the type of coverage that meets their individual needs. Available paid leave may include Paid Sick Leave, where required by law; any other paid leave required by Federal, State, or local law; and Holiday pay upon meeting eligibility criteria.
IMPORTANT: This Infusion Pharmacist job is being recruited for by Adecco's Healthcare & Life Sciences division, not your local Adecco Branch Office.
For opportunities available at Adecco Medical and Science go to www.adeccousa.com/industries/medical-and-science
Equal Opportunity Employer/Veterans/Disabled. To read our Candidate Privacy Information Statement, which explains how we will use your information, please visit http://www.adeccousa.com/candidate-privacy/ . The Company will consider qualified applicants with arrest and conviction record.
Pay Details: $70.00 to $73.00 per hour
Benefit offerings available for our associates include medical, dental, vision, life insurance, short-term disability, additional voluntary benefits, EAP program, commuter benefits and a 401K plan. Our benefit offerings provide employees the flexibility to choose the type of coverage that meets their individual needs. In addition, our associates may be eligible for paid leave including Paid Sick Leave or any other paid leave required by Federal, State, or local law, as well as Holiday pay where applicable.
Equal Opportunity Employer/Veterans/Disabled
To read our Candidate Privacy Information Statement, which explains how we will use your information, please navigate to https://www.adecco.com/en-us/candidate-privacy
The Company will consider qualified applicants with arrest and conviction records in accordance with federal, state, and local laws and/or security clearance requirements, including, as applicable:
The California Fair Chance Act
Los Angeles City Fair Chance Ordinance
Los Angeles County Fair Chance Ordinance for Employers
San Francisco Fair Chance Ordinance
