Clinical Pharmacist Utilization Management - Remote in PST

Completes assigned daily prior authorization case reviews to meet production and performance metrics as determined by the department to maintain compliant timeliness standards. Review specialty medication prior authorization requests according to established treatment protocols, clinical criteria / guidelines, regulatory requirements and member benefits to ensure consistent and accurate application of clinical criteria & the determination is made within the defined processing times to meet regulatory requirements. Knowledgeable of current and emerging clinical trends. Provide internal and external clinical pharmacy subject matter consultation to members, physicians, prescribers, nurses, and pharmacists. Proactively identify process improvement opportunities and collaborate with other teams and leaders. Assist with user acceptance testing for new clinical programs and system enhancements. Ensure and evaluate quality controls and implement opportunities for performance improvement in pharm...Pharmacist, Clinical, Management, Remote, Health, Pharmacy, Healthcare