Clinical Pharmacist - Prior Authorization (AZ Licensed)
Core
Review prior authorization requests, verify medically necessary indications, and analyze clinical documentation to support pharmacy benefit management decisions.
Role type
Senior IC clinical pharmacist (prior authorization)
Builds
Pharmacy benefit management policies and clinical support for member services
Domain
Healthcare / Pharmacy Benefit Management
Required skills
Prior authorization review, clinical documentation analysis, foreign drug review, case analysis, drug policy development, clinical project management
Preferred skills
RxClaim experience, advanced computer proficiency
Responsibilities
Review PA requests, verify proven/medically necessary indications, perform foreign drug reviews, conduct medical record reviews, provide clinical support for new drug policies, collaborate on existing policy revisions
Seniority
Mid-level, hands-on IC