Manpower Group Contract Pharmacists needed! in Durham, North Carolina
We are looking for experienced Pharmacists to join our team at a large health insurance company in Durham NC! This position is slated to begin in November 2017, and interviews are starting next week. The ideal candidate will possess their PharmD, will be authorized to work as a Pharmacist in North Carolina, and will have a retail pharmacy background.
Review prior authorization requests and make determinations for drug products according to member benefits and coverage criteria.
Report utilization review statistics to corporate compliance committees.
Review data and summarize daily utilization review numbers.
Responsible for tracking compliance of review cases.
Provide clinical guidance and support to the assigned pharmacy technicians.
Knowledge of drug coding (NDC, GCN, GPI and USC) and NCPDP claims adjudication systems.
Review guideline criteria for prior authorization and non-formulary drugs in support of Pharmacy and Therapeutics Committee function and pharmacy benefit design.
Ensure and evaluate quality controls and opportunities for performance improvement in pharmacy practices.
Research drug information to maintain drug knowledge and disease state understanding for application to prior authorization reviews.