Clinical Appeals Pharmacy Leader - New York
2 weeks ago

Job summary
Review appeals for clinical appropriateness and makes clinical decisions on approvals.
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- Doctor of Pharmacy degree or master's in pharmacy from an accredited school of pharmacy
- New York State pharmacy license preferred Board certification (Pharmacotherapy, Ambulatory Care, Geriatrics, Internal Medicine, Pediatrics) preferred10 –12+ years of relevant professional work experience 3+ years of staff and/or process management experience 5+ years of pharmacist experience Utilization Management experience Residency or 5 years' clinical experience Knowledge of pharmaceuticals and disease states to provide advice and consultation to providers and members and recommend changes to the formulary Possess research analytical skills sufficient to provide problem resolution and consultation to providers Excellent verbal written communication skills sufficient to prepare own correspondence interact with members providers in provision providence advice guidelines.
Job description
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