EmpiRx Health

Pharmacist

• Act as a clinical expert on prior authorization review and evaluation according to clinical criteria and covered plan design
• Review, evaluate, and resolve assigned clinical reviews through comprehensive case review and direct physician engagement
• Perform peer-to-peer reviews with providers as needed
• Convey clinical determinations promptly to prescribers, members, and healthcare professionals following approval and denial protocols
• Monitor and identify clinical interventions to ensure clinical savings guarantees are met
• Review current clinical literature to support recommendations and decision-making
• Participate in continuous quality improvement initiatives
• Stay informed on formulary updates, clinical programs, and internal policies
• Provide guidance and support regarding clinical inquiries
• Collaborate with clinical technicians and prior authorization team members to resolve escalations and answer inquiries
• Support staff training and development as needed
• Document cases and communications using pharmacy management software
• Use Microsoft Office tools for analysis and reporting
• Use external clinical and drug information resources such as IPD, Policy Reporter, UpToDate, and MediSpan
• Collaborate cross-functionally on claim/data review, clinical interventions, and provider/member/client support

Explore Per Diem Pharmacist at EmpiRx Health. Review requirements and application details.

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Per Diem Pharmacist