Remote Coverage Review Pharmacist
# Remote Coverage Review Pharmacist **Global Channel Management, Inc.** · United States · `Remote` · `Full Time` 💼 **Уровень роли:** `Mid-level` 🕒 **Статус:** *Опубликовано: сегодня* · *Источник: Himalayas (JSON API)* --- ### Top Skills & Match 🎯 **Ключевой стек роли:** `[Coverage-Review-Pharmacist]` `[Pharmacist]` `[Pharmacy-Specialist]` `[Clinical-Pharmacist]` `[Prior-Authorization-Pharmacist]` `[Remote-Healthcare-Reviewer]` `[Remote-Clinical-Pharmacist]` --- ### About the Role Remote Coverage Review Pharmacist needs 3 years and Doctor of Pharmacy (PharmD) Degree Coverage Review Pharmacist requires: - Clinical experience required, and/or completion of 1 year residency and/or board certification - Ability to work independently with minimal supervision or function in a team environment sharing responsibility, roles and accountability. Competency in compendia navigation and research Proficient in Microsoft Office (Outlook, Word, Excel and Powerpoint) - Must be a team player, be organized and have the ability to handle multiple projects Excellent oral and communication skills Strong interpersonal and organizational skills - Solid understanding of regulatory guidelines (FDA, NCQA, EQRO, CMS) required - Knowledge of medical and pharmacy products License Licensed in Tennessee to practice Pharmacy, or eligible for licensure in the state of Tennessee to practice Pharmacy Coverage Review Pharmacist duties: - Responsible for various activities associated with coverage reviews and appeals including the review of medication related prior authorizations, pharmacy appeals, and member grievances focused on medications. - Performs prospective and retrospective coverage reviews and appeals per State and Federal regulations - Responds to prescriber, pharmacy provider, member appeals, grievances and complaints related to the provision of pharmaceutical services within established time periods - Builds and maintains decision trees in the prior authorization system - Maintains denial rationale associated with clinical criteria and ensures that decision letters meet regulatory compliance Originally posted on Himalayas
- Coverage-Review-Pharmacist
- Pharmacist
- Pharmacy-Specialist
- Clinical-Pharmacist
- Prior-Authorization-Pharmacist
- Remote-Healthcare-Reviewer
- Remote-Clinical-Pharmacist
Наблюдалась 2026-10-10, впервые 2026-10-10, источник — Himalayas (JSON API).