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Pharmacist
2 weeks ago
Blue Health is seeking a detail-oriented and knowledgeable Pharmacist to join our team, specializing in
prior authorization support
. The role will involve working closely with healthcare providers, insurance companies, and internal teams to ensure that patients receive timely access to their prescribed therapies. The ideal candidate will possess strong clinical knowledge, excellent communication skills, and the ability to navigate complex insurance requirements.
Key Responsibilities:
- Review and process prior authorization requests for medications in compliance with payer guidelines and Blue Health protocols.
- Collaborate with physicians, nurses, and insurers to provide necessary clinical information and expedite approvals.
- Ensure accurate documentation of prior authorization activities in patient records and internal systems.
- Monitor and follow up on outstanding prior authorization requests to minimize delays in patient care.
Requirements:
- Valid Pharmacist license in good standing.
- Strong understanding of pharmacy benefit management and insurance processes.
- Excellent organizational and time-management skills.
- Proficiency in medical terminology and clinical documentation.
Qualifications:
- Doctor of Pharmacy (PharmD) or equivalent degree.
- Minimum 1–2 years of experience in a clinical, managed care, or prior authorization setting.
- Strong analytical and problem-solving skills with attention to detail.
- Ability to work independently during evening/night shifts while maintaining high professional standards.
