Clinical Review Pharmacist - 100% Remote

at Actalent in Chicago, Illinois, United States

Job Description

Job Description

Pharmacists will be reviewing members’ Utilization Management (UM) requests (i.e. formulary exceptions, prior authorization, step therapy, quantity limit exceptions). Client-specific criteria are referenced to determine if a prior authorization can be approved or denied. The work is detail-oriented and candidates will be expected to provide clinical judgement and communication.

Pharmacists will have regular communications with providers and members (if trained into Call Center Counseling).

Qualifications/years of experience:

- Doctor of Pharmacy (PharmD) or equivalent

- Current pharmacist license in good standing with the State Board of Pharmacy in the State where the candidate is licensed. *Verify by searching (State) State Board of Pharmacy, ex: Oklahoma State Board of Pharmacy (will need license number from pharmacist). Also provide transparency on any disciplinary action taken on license which is provided in the search.

Must Haves:

1. Ability to prioritize tasks and manage multiple projects simultaneously.

2. Drive to deliver results orientation.

3. A motivated self-starter who does not need constant direction or feedback to drive results.

4. Ability to make clinical decisions independently

5. Flexibility to change and resourceful

Technology Requirements:

- Proficient with learning new computer systems, basic IT trouble shooting and using multiple monitors

- Word and Excel

- Ability to type 35+ WPM

Additional Preferred Requirements:

- Previous PBM or Case/Care Management experience. Retail experience (ex: CVS, Walgreens, etc.) highly preferred vs Hospital experience

Employee Value Proposition (EVP)

100% remote role- this would be a great opportunity for someone wanting to get away from retail pharmacy

There may be an opportunity after peak season to complete training for and review specialized cases (ex: oncology, hepatitis C, and other complex conditions).

- Consultants may also be cross-trained for other departments, such as the Medication Therapy Management (MTM) team or Call Center Counseling (CCC).

About Actalent

Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500.

At Actalent, diversity and inclusion are a bridge towards the equity and success of our people. DE&I are embedded into our culture through:

+ Hiring diverse talent

+ Maintaining an inclusive environment through persistent self-reflection

+ Building a culture of care, engagement, and recognition with clear outcomes

+ Ensuring growth opportunities for our people

The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please email actalentaccommodation@actalentservices.com (%20actalentaccommodation@actalentservices.com) for other accommodation options.