Location
United States
Job Type
Full-time
Posted
July 01, 2026
Job Description
Our client, is a Health Insurance company, is looking for a Pharmacy Specialist Level 1 for their Newark, NJ/Hybrid location. Responsibilities:
+ This position is responsible for receiving verbal and written requests for prior authorization from pharmacists, physicians and/or patients and is responsible for supporting and assisting in the coordination of Pharmacy Services activities including claim utilization analysis, prescription plan design, ad-hoc reporting, correspondence and special projects. Must maintain performance in compliance with organizational or department goals and in compliance with regulatory agencies
+ Process prior authorizations received via prior authorization help line, by evaluating the medical necessity/appropriateness for specific drugs and based on medical criteria.
+ Directly interact with members physician office staff, pharmacies and internal stake holders for eligibility, coverage determination claims issues.
+...
+ This position is responsible for receiving verbal and written requests for prior authorization from pharmacists, physicians and/or patients and is responsible for supporting and assisting in the coordination of Pharmacy Services activities including claim utilization analysis, prescription plan design, ad-hoc reporting, correspondence and special projects. Must maintain performance in compliance with organizational or department goals and in compliance with regulatory agencies
+ Process prior authorizations received via prior authorization help line, by evaluating the medical necessity/appropriateness for specific drugs and based on medical criteria.
+ Directly interact with members physician office staff, pharmacies and internal stake holders for eligibility, coverage determination claims issues.
+...