This position is responsible for the processing, communicating, documenting and tracking of requests for formulary exceptions, prior authorization, and quantity exceptions, and brand override processes for delegated utilization management (UM) products and services.
This job will also be responsible for answering inbound phone calls and making calls back to Doctors.
* Responsible for handling pharmacy and physician calls related to the Clinical Review process, occasional member assistance
* Respond to all requests via written communication to the member's physician and the member that clearly details the outcome of the request
* Assists in the communication between the client and Prime in regard to policies and procedures surrounding the coverage of non-formulary medications and UM processes. (This communication includes the client's customer service representatives, groups/plans, pharmacies, and physician offices)
* Responsible for answering inbound phone calls from Doctors and Members, and placing phone calls back as necessary.
* Responsible for Insurance Verification and benefit determination for Medical Drug Review delegated Clients and medications.
Hours of operations is 7:30am - 6:30pm. Our team is flexible with schedules but there needs to be an 8 hour shift within this time frame.
1 late night shift per week is asked of all team members which is ending at 6:30pm
Position begins Jan 22, 2018 and is interviewing immediately!
Our people are everything. As a Best of Staffing® Client and Talent leader, Aerotek® Inc. has distinguished itself as a leader in recruiting and staffing services, by having a deep understanding of the intersection of talent and business. As a strategic partner to more than 17,000 clients and 300,000 contract employees every year, Aerotek's people-focused approach yields competitive advantages for its clients and rewarding careers for its contract employees. Headquartered in Hanover, Md., Aerotek operates a network of over 230 non-franchised offices with more than 6,000 internal employees dedicated to serving our customers. Aerotek is an operating company of Allegis Group, a global talent solutions provider. To learn more, visit aerotek.com.
The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please call 888-237-6835 or email accommodation@aerotek .com for other accommodation options. However, if you have questions about this position, please contact the Recruiter located at the bottom of the job posting. The Recruiter is the sole point of contact for questions about this position.