Pharmacist - RPh Operations Advisor - Specialty Medical Prior Authorization Aetna
About the position Responsibilities • Collaborating with Technicians and Nurses to process authorization requests, including answering clinical questions and collecting necessary clinical/medical data for assessments. • Coordinating timely communication of case decisions to physicians, health plans, employers, patients, and other healthcare professionals following approval and denial management processes. • Handling inbound phone calls and escalations from physicians or patients regarding Prior Authorization. • Establishing and maintaining communication among the company, health plan, and employer group staff. • Maintaining professional and technical knowledge of drug and disease-states for the Specialty Medical programs administered within the Novologix platform. • Performing other related projects and duties as assigned, including on-call and after-hours pharmacist availability. Requirements • Prior authorization experience required. • Previous pharmacy experience in retail or hospital preferred. • Active state pharmacist license in good standing required. • Basic computer skills required. • Strong organizational skills, interpersonal skills, and attention to detail. Nice-to-haves • Minimum of 2-5 years experience preferred. • Experience using MS Office and other Windows-based applications. Apply tot his job