Job Description
The Pharmacist is responsible for reviewing medication prior authorization and appeal requests to determine coverage based on clinical guidelines, pharmacy policies, and health plan benefits. This role works closely with providers, pharmacy technicians, and internal teams to evaluate clinical information, make coverage determinations, recommend formulary alternatives, and maintain compliance with applicable regulations.
This is a fast-paced, production-driven role that requires strong clinical judgment, organization, attention to detail, and the ability to manage a high volume of cases.
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