Retail Pharmacist - Prior Authorizations

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Job Summary:

This position will work remotely to support clinic and pharmacy locations, alongside Prior Authorization Billing Specialists.

Reviews and supports prior authorizations, formulary exception requests, payer denials and appeals, and other medication access activities to facilitate timely and appropriate patient access to prescribed therapies. Performs clinical review of medication refill authorization requests and medication histories, ensuring accuracy, appropriateness, adherence to clinical guidelines, and effective communication with patients and providers regarding medication therapy. Provides transitions of care services through medication reconciliation, discharge medication review, identification and resolution of medication-related problems, patient education, and collaboration with providers to promote safe and effective transitions across care settings.

ProMedica is a mission-driven, not-for-profit health care organization headquartered in Toledo, Ohio. It serves communities across nine states and provides a range of services, including acute and ambulatory care, a dental plan, and academic business lines. ProMedica owns and operates 10 hospitals and has an affiliated interest in one additional hospital. The organization employs over 1,300 health care providers through ProMedica Physicians and has more than 2,300 physicians and advanced practice providers with privileges. Committed to its mission of improving health and well-being, ProMedica has received national recognition for its clinical excellence and its initiatives to address social determinants of health. For more information about ProMedica, please visit promedica.org/aboutus. 

Benefits:

We provide flexible benefits that include compensation and programs to help you take care of your family, your finances and your personal well-being. It’s what makes us one of the best places to work, and helps our employees live and work to their fullest potential.

Qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, religion, sex/gender (including pregnancy), sexual orientation, gender identity or gender expression, age, physical or mental disability, military or protected veteran status, citizenship, familial or marital status, genetics, or any other legally protected category. In compliance with the Americans with Disabilities Act Amendment Act (ADAAA), if you have a disability and would like to request an accommodation in order to apply for a job with ProMedica, please contact employment@promedica.org

Equal Opportunity Employer/Drug-Free Workplace