Job Title: Pharmacist – Advisor Medicare
Duration: 11 Months
Location: Austin, TX 78717
Shift: Business Hours are 7am – 8pm EST Monday – Friday and 7am – 430pm EST Sat and Sunday. Set Rotation.
Position Summary:
As a Clinical Pharmacist Advisor Medicare you will be directly supporting Medicare Part D members and providers with requests related to their pharmacy benefits. You will be responsible for ensuring cases are accurately set up for our members, review clinical information for decisioning the request, performing outreach to providers for more information when needed, and ensuring accurate decisions that comply with compendia and Medicare guidance and timelines. This is a great opportunity to initiate a career with a leading healthcare company by reviewing information and completing timely and accurate documentation of all Medicare Part D requests, in compliance with Medicare guidelines, while promoting a best-in-class service experience.
Duties:
The role involves ensuring the accuracy of case setup and clinical review of Medicare appeals cases by thoroughly reviewing internal notes or fax requests for pertinent information, providing clear and concise documentation, and contacting providers when necessary to obtain clinical details for case decisions.
Experience:
Previous experience in Managed Care/PBM environment (preferred).
Education:
Bachelor’s degree in pharmacy or Pharm D. required. Must have an active license in good standing in state of residence.