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Oncology pharmacist • chattanooga tn
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Coverage Review Pharmacist
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Description
- Responsible for various activities associated with coverage reviews and appeals including the review of medication related prior authorizations, pharmacy appeals, and member grievances focused on medications.
- Performs prospective and retrospective coverage reviews and appeals per State and Federal regulations
- Responds to prescriber, pharmacy provider, member appeals, grievances and complaints related to the provision of pharmaceutical services within established time periods
- Builds and maintains decision trees in the prior authorization system
- Maintains denial rationale associated with clinical criteria and ensures that decision letters meet regulatory compliance
Top Skills Details
PharmD, Medicare Coverage, and / or Prior Authorization Experience
Additional Skills & Qualifications
Skills\Certifications - Ability to work independently with minimal supervision or function in a team environment sharing responsibility, roles and accountability.
Experience Level
Intermediate Level
Setting
100% Remote - MUST reside within 2 hours of Chattanooga, TN
Job Type & Location
This is a Contract position based out of Chattanooga, TN.
Pay and Benefits
The pay range for this position is $67.48 - $67.48 / hr.
Eligibility requirements apply to some benefits and may depend on your job
classification and length of employment. Benefits are subject to change and may be
subject to specific elections, plan, or program terms. If eligible, the benefits
available for this temporary role may include the following :
Workplace Type
This is a fully remote position.
Application Deadline
This position is anticipated to close on Dec 1, 2025.