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Pharmacist Analyst

USA, Remote
Role: Pharmacist Analyst
Location: Remote
Duration: 11+ Months

Hiring process:   Phone Interview
Onboarding process: Paperwork + BGC+ DT
 
Note: Virtual Work(100% Remote), Laptop Will Be Provided By Company For Work. 
 

Job Description
A Lead is responsible for supporting the Medicaid Operations team’s strategy to achieve operational excellence and provide consistent clinical decisions for our beneficiaries. He/she is responsible for supporting the Supervisor and team with untimeliness review, providing oversight of ALJ Hearings and outcomes, productivity, quality, and attendance of the Clinical Pharmacists. He/she must be able to guide his/her pharmacist peers to apply their clinical, regulatory, and systems knowledge to analyze case process and CMS guidance and to make accurate and timely decisions for our beneficiaries. The Lead Rph must also be able to review clinical coverage determination and appeal requests as a licensed pharmacist (per state requirements), in accordance with CMS Parts C & D Enrollee Grievances, Organization/Coverage Determinations, and Appeals Guidance, which states only a pharmacist can deny a coverage determination for Medicare Part D beneficiaries. He/she must be knowledgeable in all aspects of the coverage determination and appeals processes and assist in meeting clients expectations regarding efficiency, services levels, privacy maintenance and quality decision making. The IRE Lead Rph will work as part of the team to meet business unit objectives and will be responsible for applying their clinical expertise in their decisions, as well as potentially participating in various clinical projects.

Required Qualifications
•           Active Pharmacist license in good standing in the state the Rph resides.
•           Medicaid or Medicare experience.
•           Experience with Excel, Windows.

Preferred Qualifications
Doctorate degree
Prior Leadership experience
Education
Bachelors Degree required, Doctorate preferred




Regards,

Rahul Yadav
(408) 560-3956
rahul@reqroute.com
http://reqroute.catsone.com/careers/index.php (Click to see MOST Current Openings)

 
Companies across U.S. have engaged ReqRoute, Inc to deliver skilled, dedicated IT professionals. Recruiting is our passion and we support Fortune 1000 companies with their hiring needs. We always seek to deliver competitive and sought-after career opportunities to our potential consultants and employees. We invite you to review the position requirements and apply today if your skills match our needs.  
 
ReqRoute, Inc is an Equal Opportunity Employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, disability, military status, national origin or any other characteristic protected under federal, state, or applicable local law. (www.reqroute.com)

 

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