Pharmacy Program Coordinator - Clinical Prior Authorization - RemoteCedars-Sinai Medical Center • Los Angeles, California, United States
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Pharmacy Program Coordinator - Clinical Prior Authorization - Remote
Cedars-Sinai Medical Center
- Los Angeles, California, United States
- Los Angeles, California, United States
Über
The employee is required to be onsite once a month for regulatory inspection of medication storage.
The Remote Clinical Prior Authorization Pharmacist Specialist will collaborate with the Prior Authorization Pharmacy Technician, Drug Use Policy, and authorizing providers to ensure safe, effective, and reasonable use of high‑cost drug therapies. The role supports timely patient treatment and optimizes reimbursement for these medications, assists with appeal processes, performs payor update reviews, claim data analysis, and incorporates payor clinical criteria into medication use guidelines. Additional responsibilities include navigating and obtaining payer coverage approval to facilitate discharge and prevent admission.
The Pharmacist is responsible for clinical pharmacy services, including but not limited to identification of drug‑related problems, identification of medication safety issues, review of medication orders for appropriateness, and provision of in‑services/drug information to outpatient clinic sites and patients. The Clinical Prior Authorization Pharmacist Specialist will also supervise the associated pharmacy technicians.
Qualifications Educational Requirements
Pharm.D. or equivalent degree from an accredited school of pharmacy.
Licenses & Certifications
Current pharmacist licensure in the State of California.
BLS certification as outlined in Cardiopulmonary Resuscitation (CPR) guidelines.
Other Qualifications
Completion of a PGY1 residency or equivalent practice experience; prior authorization experience is highly preferred.
Excellent clinical data base and experience in Medication Use Evaluation.
Excellent verbal and written communication skills.
Proficiency in Microsoft Office.
Comprehensive knowledge of medical terminology related to drug usage.
Comprehensive knowledge of common disease states and pathologies.
Ability to comprehend patient medical management plans and apply pharmacological principles to drug selection and use.
Ability to extract pertinent information from patients and other sources, and relate it to patient care plans.
Ability to teach and serve as a preceptor for training programs.
Ability to prepare drugs needed for immediate administration.
Ability to provide recommendations and monitor drug use.
Knowledge of laws, regulations, and standards related to pharmacy practice.
Adaptability to change and prioritization of workflow.
Ability to evaluate medication regimens to meet therapeutic needs of patients.
Competency in pharmaceutical calculations, compounding, and pharmacokinetics.
Competent computer skills necessary to perform job functions.
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Sprachkenntnisse
- English
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