Prescription Solutions helps consumers obtain the medications and products they need to live healthier lives. Services offered by the company include pharmacy network contracting, rebate contracting and administration, mail order pharmacy facilities, specialty drugs and retail drug claims processing. The company is one of only three in the United States to have received URAC dual accreditation and provides clinical services to help its clients provide cost effective, quality-driven results.
The company is part of Pharmacy Services group, within Enterprise Services, a family of UnitedHealth Group businesses dedicated to improving the health and well-being of Americans.
Primary Responsibilities: Clinical Pharmacist working in the Prior Authorization unit within Customer Service department of Prescription Solutions. Primary role is reviewing Prior Authorization cases and rendering coverage determinations based on clinical criteria and plan design. Consult physicians with questions and interpretations of clinical guideline criteria and coverage determinations rendered. Participate in inter-department meetings with the Clinical Services & Client Management teams of Prescription Solutions. Participate and contribute to Prior Authorization clinical medication guideline development and revision process. Participate in quality improvement and process enhancement projects as assigned by management.
Qualifications
- Current and unrestricted Pharmacist license for the State of CA
- 1-3 years practicing pharmacist experience
- Strong drug product and clinical pharmacy knowledge
- Computer proficiency required including MS Office applications (Word, Excel, PowerPoint, Outlook, etc.)
- Excellent written and oral communication skills
- Excellent interpersonal and problem-solving skills
- Strong customer service skills and commitment to professionalism
- Demonstrated ability to work independently with minimal supervision
Preferred Assets:
- 1-3 years pharmacist experience working in a clinical pharmacy practice setting
- Pharm.D degree
- Completion of Pharmacy Residency
- Experience working with a PBM company or Managed Healthcare System
- Experience developing or operationalizing medication clinical guidelines and/or formulary development
Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.
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