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

  • 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 company 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 Bachelors’ in Pharmacy or Pharm D
  • Clear and active Pharmacist license in the state of NV
  • 1-2 year of experience in a specialty or high-volume retail pharmacy
  • Complete flexibility in work schedule to work in a fast-paced call center environment
  • Proficient with computers

Additional Information

Hours for this Position:

M-Sun, 8hr shift between 4am-8pm (possible OT)

Pay Rate:  $55-58.00 (negotiated)


Advantages of this Opportunity: 

• Competitive salary, based on relevant experience

• Career advancement with prestigious healthcare company

• Fun and positive work environment