Job Summary

As a licensed healthcare professional employed in the Prior Authorization Department, the primary responsibility of the Pharmacist (R) is to make determinations on prior authorization requests for coverage of pharmaceutical products. Determinations include medical necessity and benefit decisions. Decisions are made in accordance with established pharmacy guidelines, prior authorization criteria, industry regulations and sound clinical judgment.

The incumbent works independently with respect to reviews and decision making, with the support of Pharmacist II (R)s and supervisors. The Pharmacist (R) works as a member of a team of peers committed to meeting or exceeding quality standards and customer performance guarantees.

Work Arrangement:

• Fully Remote
• Schedule Monday through Friday, 12:30 p.m. EST to 9:00 p.m. EST,and 8:30 a.m. EST to 5:00 p.m. ESTevery 4th weekend.
• Candidates Must Reside in North Carolina

Additional responsibilities include :

• Provide clinical support to the PerformRx Customer Care Center.
• Engage Providers in discussions to support determinations.
• Support Fraud and Abuse program oversight.
• Keep abreast of industry trends and regulatory changes.
• Keep abreast of operational directives and customer reference materials.

Education/Experience:

• Bachelor's Degree in Pharmacyrequired.
• Pharm.D. preferred.
• CurrentState of North Carolinapharmacy licenserequired.
• Current Pharmacist license in good standingrequired.
• Experience in an aspect of pharmacy; PBM experience preferred.

Our Comprehensive Benefits Package

Flexible work solutions including remote options, hybrid work schedules, Competitive pay, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement and more.

For roles that are 100% remote or hybrid, you must have access to a reliable high-speed internet connection to support daily job responsibilities. A minimum bandwidth of 50 Mbps download and 5 Mbps upload is required. Those fully remote associates residing in states where service is required by contract, law, or regulation will be allowed to submit for reimbursement.

Your career starts now. We're looking for the next generation of health care leaders.