Clinical Pharmacist Advisor Medicare # 26-23269
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Overview
Remote
On-site
Compensation
$53-$57/hour
Job Description
Duration: 12 Month Job Description:
- Shift: Business Hours are 7am- 8pm EST Monday- Friday and 7am- 430pm EST Sat and Sunday. Set Rotation.
- Licensed Registered Pharmacist in state of residence
- The role involves ensuring the accuracy of case setup and clinical review of Medicare appeals cases by thoroughly reviewing internal notes or fax requests for pertinent information, providing clear and concise documentation, and contacting providers when necessary to obtain clinical details for case decisions.
- It requires adherence to work instructions and Medicare guidelines to ensure proper case processing.
- The position also demands compliance with CMS-mandated timelines, as well as departmental productivity and quality standards.
- Clinical judgment and knowledge must be applied effectively, utilizing drug compendia resources, evolving work instructions, and CMS Medicare guidance.
- Additionally, the role includes participating in development discussions and receiving feedback from the direct supervisor to support continuous improvement.
- The role involves ensuring the accuracy of case setup and clinical review of Medicare appeals cases by thoroughly reviewing internal notes or fax requests for pertinent information, providing clear and concise documentation, and contacting providers when necessary to obtain clinical details for case decisions.
- It requires adherence to work instructions and Medicare guidelines to ensure proper case processing.
- The position also demands compliance with CMS-mandated timelines, as well as departmental productivity and quality standards.
- Clinical judgment and knowledge must be applied effectively, utilizing drug compendia resources, evolving work instructions, and CMS Medicare guidance.
- Additionally, the role includes participating in development discussions and receiving feedback from the direct supervisor to support continuous improvement
- Previous experience in Managed Care/PBM environment (preferred).
- Knowledge of Access, Power Point, and Visio is preferable.
- Must be computer literate – knowledge of Excel and Word.
- Bachelor's degree in pharmacy or Pharm D. required.
- Must have an active license in good standing in state of residence.
Automate your job search with Sonara.
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FAQs About Clinical Pharmacist Advisor Medicare # 26-23269 Jobs at US Tech Solutions, Inc.
What is the work location for this position at US Tech Solutions, Inc.?
This job at US Tech Solutions, Inc. is located in Woonsocket, RI, according to the details provided by the employer. Some roles may also include multiple work locations depending on the requirement.
What pay range can candidates expect for this role at US Tech Solutions, Inc.?
Candidates can expect a pay range of $53–$57 per hour for this role.
What employment applies to this position at US Tech Solutions, Inc.?
The employer has not provided this information. This may be discussed during the hiring process.
What is the process to apply for this position at US Tech Solutions, Inc.?
You can apply for this role at US Tech Solutions, Inc. either through Sonara's automated application system, which helps you submit applications 10X faster with minimal effort, or by applying manually using the direct link on the job page.