Knowledge of Access, Power Point, and Visio is preferable.
Must be computer literate knowledge of Excel and Word.
Licensed Registered Pharmacist in state of residence
***Must provide a copy Registered Pharmacist License with Resume in state of residence***
**include state & time zone on resume**
As an RPh Advisor you will be directly supporting Medicare Part D members and providers with requests related to their pharmacy benefits. You will be responsible for ensuring cases are accurately set up for our members, review clinical information for decisioning the request, performing outreach to providers for more information when needed, and ensuring accurate decisions that comply with compendia and Medicare guidance and timelines. This is a great opportunity to initiate a career with a leading healthcare company by reviewing information and completing timely and accurate documentation of all Medicare Part D requests, in compliance with Medicare guidelines, while promoting a best-in-class service experience.
Attendance is extremely important, especially during the initial 8 weeks of training. The new hire must be available M-F from 9am-5:30pm EST for the first 8 weeks (no vacation time planned).
Do you have any conflicts with the training schedule or time off planned during assignment duration?
After training, our hours of operation are an 8 hours shift between 8AM - 8PM EST/CST M-F with rotating weekend schedules 7AM - 330PM EST/CST. they must be available for the rotating weekend.
Do you have any conflicts working an assigned 8-hour shift between 8AM to 8PM EST/CST - 8hours per day M-F or 7AM-330PM EST/CST rotating weekends
This is a work from home (WFH) position; must have a dedicated quiet, separate space in which to work with wired internet meeting 25mbps min download and 5mbps minimum upload speed. Previous WFH experience is preferred.
Do you have a separate workspace with no interruptions?
Please include internet speed
Must be able to sit and focus on work for the duration of shift.
Are you able to sit and focus with no interruptions for entire shift?
Data entry and navigating multiple computer applications while utilizing two screens is the primary function of job (possible outbound calls needed). A job history demonstrating this is recommended.
Do you have data entry experience?
Active Pharmacist license is required in the state you live in.
Successfully worked independently in a data entry, productivity driven role is preferred
Are you able to work independently?
As a company we strive for a team that is engaged and positive so candidates that demonstrate this would be ideal
Do you feel you have the engagement and positive attitude to work this assignment?
Additional Details
Is this request for Peak Season? Select applicable value : RAMP - CD&A
Duties : Responsibilities 1. Collaborates with multiple groups within CD&A, including answering clinical questions, collecting appropriate clinical/ medical data needed to perform clinical assessments, and reviews as per the health plan/employer agreed criteria within the designated service level agreements. (20%) 2. Coordinates timely communication of case decision to physician, health-plan/employer, patient and other healthcare professionals following agreed upon approval & denial management processes. (20%) 3. Reviews cases in progress and provides a Clinical decision regarding Prior Authorizations, Tier Exceptions and Non-Formulary requests (50%) 6. Performs other related projects and duties as assigned including on call and after hours pharmacist availability could be required. (10%) Knowledge of Access, Power Point, and Visio is preferable. Must be computer literate knowledge of Excel and Word. Licensed Registered Pharmacist in state of residence
Experience : Minimum 1 year of experience although 2-5 years is preferred Knowledge of Access, Power Point, and Visio is preferable. Must be computer literate knowledge of Excel and Word. Licensed Registered Pharmacist in state of residence
Position Summary : As an RPh Advisor you will be directly supporting Medicare Part D members and providers with requests related to their pharmacy benefits. You will be responsible for ensuring cases are accurately set up for our members, review clinical information for decisioning the request, performing outreach to providers for more information when needed, and ensuring accurate decisions that comply with compendia and Medicare guidance and timelines. This is a great opportunity to initiate a career with a leading healthcare company by reviewing information and completing timely and accurate documentation of all Medicare Part D requests, in compliance with Medicare guidelines, while promoting a best-in-class service experience.
Education : Bachelor's Degree Required, Pharm D Preferred Licensed Registered Pharmacist in state of residence
What days & hours will the person work in this position? List training hours, if different. : 8am to 8pm EST/CST - 8hours per day M-F 7am-330p EST/CST rotating weekends
Qualification Assessment Must Have CVS Caremark Requirements
Prior CVS/Aetna work experience?
No
Verifyable High School Diploma or GED Required
Yes Is this request for Peak Season? Select applicable value
RAMP - CD&A
Duties
Responsibilities
Collaborates with multiple groups within CD&A, including answering clinical questions, collecting appropriate clinical/ medical data needed to perform clinical assessments, and reviews as per the health plan/employer agreed criteria within the designated service level agreements. (20%)
Coordinates timely communication of case decision to physician, health-plan/employer, patient and other healthcare professionals following agreed upon approval & denial management processes. (20%)
Reviews cases in progress and provides a Clinical decision regarding Prior Authorizations, Tier Exceptions and Non-Formulary requests (50%)
Performs other related projects and duties as assigned including on call and after hours pharmacist availability could be required. (10%)
Knowledge of Access, Power Point, and Visio is preferable.
Must be computer literate knowledge of Excel and Word.
Licensed Registered Pharmacist in state of residence
Experience
Minimum 1 year of experience although 2-5 years is preferred
Knowledge of Access, Power Point, and Visio is preferable.
Must be computer literate knowledge of Excel and Word.
Licensed Registered Pharmacist in state of residence
Position Summary
As an RPh Advisor you will be directly supporting Medicare Part D members and providers with requests related to their pharmacy benefits. You will be responsible for ensuring cases are accurately set up for our members, review clinical information for decisioning the request, performing outreach to providers for more information when needed, and ensuring accurate decisions that comply with compendia and Medicare guidance and timelines. This is a great opportunity to initiate a career with a leading healthcare company by reviewing information and completing timely and accurate documentation of all Medicare Part D requests, in compliance with Medicare guidelines, while promoting a best-in-class service experience.
Education
Bachelor's Degree Required, Pharm D Preferred
Licensed Registered Pharmacist in state of residence
What days & hours will the person work in this position? List training hours, if different.
8am to 8pm EST/CST - 8hours per day M-F 7am-330p EST/CST rotating weekends
Type of Start
Class with set start date
Program Office - Point Of Contact
Joelle Brown
Is this an in-person, patient-facing role?
No
Onsite Requirements
Fully remote (never coming onsite)
Seniority level
Entry level
Employment type
Full-time
Job function
Other
Industries
IT Services and IT Consulting
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