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Prior Authorization Pharmacist

Overview of Position

As part of the Change Healthcare Pharmacy Benefit Administration (PBA) business unit, the PBA Prior Authorization Pharmacist is responsible for reviewing prior authorization requests based on the Ohio Medicaid fee-for-service (FFS) account requirements, responding to inquiries from providers, and providing other clinical support roles.

Location: Remote/Telecommuter position but must be willing to work East Coast hours

What will be my duties and responsibilities in this job?

• Review prior authorization requests and make determinations for drug products according to member benefits, established treatment protocols, and clinical criteria
• Research the medical literature and drug information database to maintain drug knowledge and disease state understanding for application to prior authorization reviews
• Support the determination, appeal, and grievance process
• Make prior authorization determinations within the defined turnaround times

What are the requirements needed for this position?

• Strong written and verbal communication skills
• Bachelor's degree in Pharmacy with optional post-graduate training or related field or equivalent work experience required
• Required: Registered pharmacist in good standing with a valid Ohio Pharmacist License or eligible for reciprocity

What other skills/experience would be helpful to have?

• Doctor of Pharmacy (PharmD)
• 2+ years of managed care pharmacy or pharmacy benefit management (PBM) experience

What are the working conditions and physical requirements of this job?

General office demands

How much should I expect to travel?

None

#li-remote

Join our team today where we are creating a better coordinated, increasingly collaborative, and more efficient healthcare system!

COVID Vaccination Requirements

We remain committed to doing our part to ensure the health, safety, and well-being of our team members and our communities. As such, we require all employees to disclose COVID-19 vaccination status prior to beginning employment and we may require periodic testing for certain roles. In addition, some roles require full COVID-19 vaccination as an essential job function. Change Healthcare adheres to COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance.

Equal Opportunity/Affirmative Action Statement

Change Healthcare is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, genetic information, national origin, disability, or veteran status. To read more about employment discrimination protections under federal law, read EEO is the Law at https://www.eeoc.gov/employers/eeo-law-poster and the supplemental information at https://www.dol.gov/ofccp/regs/compliance/posters/pdf/OFCCP_EEO_Supplement_Final_JRF_QA_508c.pdf.

If you need a reasonable accommodation to assist with your application for employment, please contact us by sending an email to [email protected] with "Applicant requesting reasonable accommodation" as the subject. Resumes or CVs submitted to this email box will not be accepted.

Click here https://www.dol.gov/ofccp/pdf/pay-transp_%20English_formattedESQA508c.pdf to view our pay transparency nondiscrimination policy.

California (US) Residents: By submitting an application to Change Healthcare for consideration of any employment opportunity, you acknowledge that you have read and understood Change Healthcare?s Privacy Notice to California Job Applicants Regarding the Collection of Personal Information.

Change Healthcare maintains a drug free workplace and conducts pre-employment drug-testing, where applicable, in accordance with federal, state and local laws.