Appeals Pharmacist at Adecco USA

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.

Type:               Eight-month contract, possibility for extension or fulltime offer

Schedule:        Monday through Friday 8a-5p OR 9a-6p local time with rotational weekend hours and some holiday coverage

Pay:                 $65.50 an hour

Responsibilities of the Appeals Pharmacist:

•         Evaluate prescriptions and patient histories

•         Interpret physicians' prescriptions and clinical documentation, accesses clinical criteria and compendia support

•         Consult with customers, patients and/or physicians regarding use of medications, potential drug interactions, and clinical status for appeals requests

•         Conduct Quality Assurance and verify the accuracy of all prescriptions to render appeal decision

•         Provide explanations and interpretations within area of expertise

•         Review formulary and utilization management guidelines to determine if the drug should be a covered benefit for the beneficiary based on their medical history

•         Research, evaluate, and make determinations on member and provider appeals of pharmacy coverage decisions

•         Gather complex clinical information, consider approved compendia, medical literature, coverage policy, and criteria information and work within regulatory guidelines to render decisions.

•         Decision may require consulting with Plan Medical Directors and the beneficiaries treating physician

•         Answer questions from support personnel regarding prescription drugs

•         Position requires excellent record keeping skills, thorough documentation, clear and concise written/verbal communications skills

Qualifications of the Pharmacist:

•         BS in Pharmacy degree

•         Active and unrestricted Pharmacist license in state of residence

•         Experience using online clinical references and accessing professional (clinical and regulatory) internet sites

•         Experience in Coverage Determinations (prior authorization) or member appeals

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

Equal Opportunity Employer/Veterans/Disabled. To read our Candidate Privacy Information Statement, which explains how we will use your information, please visit

. The Company will consider qualified applicants with arrest and conviction record.

Pay Details: $63.00 to $65.79 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

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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