Clinical Pharmacist Advisor Medicare - US Tech Solutions, Inc.

Position Summary:

This position is responsible for dispensing prescriptions and coordinating clinical services for specialty drugs serviced at the branch location. This position is responsible for interacting with the health care professionals in the provision and coordination of customer care. Must also translate prescriptions, perform compounds and dispense prescribed pharmaceuticals. Must be comfortable communicating by telephone or mail, with patients and physicians for patient care. Will also be responsible for resolving orders via the EA (External Adjudication) queue.

Duties:

Ensure accuracy of case setup and clinical review of Medicare appeals cases
Review internal notes or fax requests thoroughly for pertinent information
Provide clear, concise, and accurate documentation for case reviews
Contacting providers, if needed, for clinical information to decision cases
Utilize work instructions and Medicare guidelines for accurate case processing

Comply with CMS mandated timelines and department productivity and quality standards Acquire and utilize clinical judgement and knowledge, drug compendia resources, relevant and changing work instructions, and CMS Medicare guidance Participate in development discussions receiving feedback from direct supervisor.

This is a remote role, open to qualified candidates within the United States. Operational hours are 7am-8pm ET M-F, 7am-5pm ET on weekends. The RPh Advisor is expected to show flexibility in working with a rotating schedule, including overtime, evenings, weekends, and holidays.

Experience:

- Active pharmacist license in the state of residence that is in good standing
- Ability to utilize multiple software systems, simultaneously with a 2-screen workstation setup (Windows based operations, AS400, MHK, PeopleSafe, WI database, Microsoft office applications)
- Ability to type 30 WPM or greater
- Ability to utilize compendia (Micromedex, Lexicomp, etc) to evaluate and support case decisions
- Excellent oral and written communication skills
- Ability to multi-task, prioritize, and manage time effectively in a fast-paced, highly regulated environment
- Must be able to review large volume of information, determine importance, and apply clinical knowledge to assist in outcome
- Demonstrated ability to work independently and utilize critical thinking/problem solving skills to make case decisions
- Receptive to constructive feedback and flexible in adapting to change
- Flexibility with working a rotating schedule including overtime, weekends, and holidays

Education:

High School Diploma or GED required. Bachelor's degree in pharmacy or Pharm D. also required with at least two years experience as a pharmacist. Must have an active license in good standing.

US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions. To know more about US Tech Solutions, please visit www.ustechsolutions.com.
 
US Tech Solutions is an Equal Opportunity Employer.  All qualified applicants will receive consideration for employment without regard to race, colour, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.