Req ID: RQ197951
Type of Requisition: Regular
Clearance Level Must Be Able to Obtain: None
Public Trust/Other Required: None
Job Family: Healthcare Evaluation
Skills:
Call Center,Clinical Information Systems,Customer Service,Documentations,Health Care
Experience:
1 + years of related experience
US Citizenship Required:
Yes
Job Description:
Healthcare Clinical Evaluator Advisor-Pharmacist
Drive better health outcomes for our clients as a Pharmacists at GDIT. Here, your work will impact many as you deliver healthcare expertise and services where they are needed most.
At GDIT, people are our differentiator. As a Pharmacist you will help ensure today is safe and tomorrow is smarter. Our work depends on a Pharmacist joining our team to provide world class customer service to our client. We are looking for a detail oriented, customer
focused Pharmacist to support our Prior Approval team in a call center environment. The Pharmacist will review prior approval request using clinical information to ensure timely adjudication, accurate decisions in compliance with State approved clinical criteria.
HOW A HEALTHCARE CLINICAL EVALUATOR ADVISOR-Pharmacist WILL MAKE AN IMPACT
Responsible for reviewing prior approval requests by reviewing patient-specific clinical documentation, treatment history, and preferred drug list.
You will work as a individual contributor to ensure that prior approval requests are adjudicated in a timely manner assisting with meeting SLA requirements.
You will be working with a team of Pharmacists and pharmacy technicians to ensure that we are properly adjudicating prior approval requests in accordance with North Carolina's approved criteria. Answer incoming calls related to PA requirements, status updates,
or general inquiries, providing world class customer service.
Recognizes, evaluates, interprets, recommends and implements policies and procedures for specific components of pharmacy services.
Provide medical expertise in prior approval pharmacy services.
WHAT YOU'LL NEED TO SUCCEED:
Education: PharmD or undergraduate degree in Pharmacy with residency or advanced clinical experience. Unrestricted State Licensure Required.
Required Experience: 8+ years of clinical Pharmacy experience
Required Technical Skills:
Working knowledge of how to navigate computer systems, email, Microsoft suite (Word, Excel, PowerPoint etc.), telephone software.
Required Skills and Abilities: Ability to work independently, strong
communication skills, ability to problem solve and facilitate agreement, ability to work a weekly rotating schedule to include weekends and holidays.
Preferred Skills:
Familiarity with Medicaid, Medicare Part D, or PBM operations. Prior experience with call center operations or customer service roles a plus
Location: Hybrid
US Citizenship Required
GDIT IS YOUR PLACE:
401K with company match
Comprehensive health and wellness packages
Internal mobility team dedicated to helping you own your career
Professional growth opportunities including paid education and certifications
Cutting-edge technology you can learn from
Rest and recharge with paid vacation and holidays
The likely salary range for this position is $127,254 - $146,342. This is not, however, a guarantee of compensation or salary. Rather, salary will be set based on experience, geographic location and possibly contractual requirements and could fall outside of this range.
Our benefits package for all US-based employees includes a variety of medical plan options, some with Health Savings Accounts, dental plan options, a vision plan, and a 401(k) plan offering the ability to contribute both pre and post-tax dollars up to the IRS annual limits and receive a company match. To encourage work/life balance, GDIT offers employees full flex work weeks where possible and a variety of paid time off plans, including vacation, sick and personal time, holidays, paid parental, military, bereavement and jury duty leave. GDIT typically provides new employees with 15 days of paid leave per calendar year to be used for vacations, personal business, and illness and an additional 10 paid holidays per year. Paid leave and paid holidays are prorated based on the employee's date of hire. The GDIT Paid Family Leave program provides a total of up to 160 hours of paid leave in a rolling 12 month period for eligible employees. To ensure our employees are able to protect their income, other offerings such as short and long-term disability benefits, life, accidental death and dismemberment, personal accident, critical illness and business travel and accident insurance are provided or available. We regularly review our Total Rewards package to ensure our offerings are competitive and reflect what our employees have told us they value most.
We are GDIT. A global technology and professional services company that delivers consulting, technology and mission services to every major agency across the U.S. government, defense and intelligence community. Our 30,000 experts extract the power of technology to create immediate value and deliver solutions at the edge of innovation. We operate across 30 countries worldwide, offering leading capabilities in digital modernization, AI/ML, Cloud, Cyber and application development. Together with our clients, we strive to create a safer, smarter world by harnessing the power of deep expertise and advanced technology.
We connect people with the most impactful client missions, creating an unparalleled work experience that allows them to see their impact every day. We create opportunities for our people to lead and learn simultaneously. From securing our nation's most sensitive systems, to enabling digital transformation and cloud adoption, our people are the ones who make change real.
Equal Opportunity Employer / Individuals with Disabilities / Protected Veterans