• Job Description

  Req#: RQ197951

  Type of Requisition:

  Regular

  Clearance Level Must Currently Possess:

  None

  Clearance Level Must Be Able to Obtain:

  None

  Public Trust/Other Required:

  None

  Job Family:

  Healthcare Evaluation

  Job Qualifications:

  Skills:

  Call Center, Clinical Information Systems, Customer Service, Documentations, Health Care

  Certifications:

  None

  Experience:

  8 + 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.

  Scheduled Weekly Hours:

  40

  Travel Required:

  Less than 10%

  Telecommuting Options:

  Hybrid

  Work Location:

  USA NC Home Office (NCHOME)

  Additional Work Locations:

  Total Rewards at GDIT:

  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. 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

• About the company

  General Dynamics Mission Systems is a business unit of American defense and aerospace company General Dynamics. General Dynamics Mission Systems integrates secure communication and information systems and technology

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