Apex Systems LLC, a division of On Assignment, is an IT staffing and services firm specializing in providing IT professionals for contract, contract-to-hire, and direct placements. Apex also offers recruitment solutions for other select professional skills and workforce needs
Job DescriptionDescription: The Clinical Pharmacist conducts collection of appropriate clinical/ medical data needed to perform clinical assessments and/or reviews as per the health plan/employer agreed criteria, including inbound from the coordinator as needed as well as outreach calls to physician offices. *Conducts prospective, concurrent, and/or retrospective review of cases using healthplan/employer agreed upon criteria. *Documentation of required clinical/ medical data that support case decision as required - electronically and/or in written format. *Coordinates timely communication of case decision to physician, healthplan/employer, patient and other healthcare professionals, and internal departments within CVS\Caremark following agreed upon approval & denial management processes. *Generates, reviews and validates reporting related of program results *Participate in implementation of new Specialty Pharmacy Programs with employers and health plans as needed. Implementation includes discussion of existing clinical guidelines, individualization of clinical guidelines, processes and procedures to health plan/employer specifics, and review of denial management processes. *Documentation and validation of client specific processes including communication procedures plan demographics, criteria selection, denial management procedures, and reporting requirements. *Facilitation of documentation of program agreement with client
The duties and responsibilities include but not limited to reviewing and approving prior authorizations, reviewing clinical information, making clinical decisions for appropriateness of therapy for various disease states including oncology, infertility, autoimmune diseases and many others. Clinical experience is desired (hospital or PBM). Strong verbal and written communication skills, above average computer skills, problem resolution and leadership characteristics required.
Pharmacists must be available to work any 8 hour shift between 7:30 AM and 6:30 PM, Monday through Friday.
QualificationsPharmacy knowledge; Microsoft Office literacy; Excellent oral and written communication skills; 6 months’ minimum experience preferably in retail, hospital, or managed care setting. Exposure to clinical and analytical problem solving. Pharmacy license is required.
Additional InformationApply Now and look for Ron Autor! 469-729-5756
All your information will be kept confidential according to EEO guidelines.
Skills Required
- Pharmacy knowledge
- Microsoft Office literacy
- Excellent oral and written communication skills
- 6 months' minimum experience in retail, hospital, or managed care setting
- Pharmacy license
Apex Systems Compensation & Benefits Highlights
The following summarizes recurring compensation and benefits themes identified from responses generated by popular LLMs to common candidate questions about Apex Systems and has not been reviewed or approved by Apex Systems.
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Healthcare Strength — Health benefits include medical, dental, vision, life insurance, and short- and long-term disability, and are described as good or comprehensive for internal employees. In some cases the health package is called generous.
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Retirement Support — Retirement offerings include a 401(k) plan with company match for U.S. employees and Registered Retirement Plans in Canada. These programs sit alongside core benefits for internal staff.
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Leave & Time Off Breadth — Internal full-time employees receive vacation and holiday pay, paid parental leave, and PTO that can be flexible or expand with tenure. Some internal roles note unlimited PTO after one year.
Apex Systems Insights
What We Do
Apex Systems is a world class technology services business that incorporates industry insights and experience to deliver solutions that fulfill our clients’ digital visions. We provide a continuum of service from workforce mobilization and modern enterprise solutions to digital innovation to drive better results and bring more value to our clients. Apex transforms our customers with modern enterprise solutions tailored to the industries we serve. Apex has a presence in over 70 markets across the US, Canada, and Mexico.
