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Pharmacist - Clinical Prior AuthorizationRequisition # HRC0354569 Apply Now
Are you passionate about helping people?
Cedars-Sinai Medical Center is an 886-bed acute, quaternary teaching care hospital located in the heart of Los Angeles, California. We have grown to become one of the leading medical centers in the world...through inspired leadership; centers of excellence; cutting edge evidence-based practice; distinguished physicians; groundbreaking research and advanced technology.
Do you work well in a large team environment where critical thinking is essential?
Pharmacists are crucial partners in the care team of every patient at Cedars-Sinai. Our patients have many different needs, from pain management after surgery, to coordinating 35 different drugs to prevent organ rejection after transplantation, to just getting the right prescription after a routine check-up. In every case, we are committed to ensuring the safest, most effective medication is given every time. Our pharmacists are key members of the expert team of physicians, nurses and other healthcare professionals who make Cedars-Sinai known around the world. The Pharmacy Department consists of more than 400 staff members providing industry-leading, evidence-based medicine.
The Clinical Prior Authorization Pharmacist at Cedars-Sinai Medical Center will be responsible for supporting clinical evaluation and prior authorization, preventing denials, providing patient advocacy and assistance, and evaluating payer (insurance) drug criteria usage guidelines. Specialists will be dedicated to support either oncology or medicine patients-see Qualifications below for specific requirements.
The pharmacist will collaborate with physicians, nurses, admissions staff, finance and contracting to provide care for outpatients receiving infusion and injection therapies to manage complex diseases. Patient populations include solid and hematologic transplants, irritable bowel disease, neurology, cancer and orphan diseases. Specialist positions in oncology and non-oncology
· Provide clinical evaluation and review of complex and high cost outpatient drug therapies and EHR documentation
· Evaluate payer-specific clinical requirements
· Provide ongoing review, interpretation, and communication of payor drug contract changes
· Provide clinical denials data analysis to prevent future occurrences and identify trends
· Provide clinical denials and appeals support
The pharmacist will also be responsible for staffing coverage approximately 2 days/month, in their respective area of expertise
Why work here?
Beyond outstanding benefits, competitive salaries and health and dental insurance We take pride in hiring the best, most passionate employees. Our talented staff reflects the culturally and ethnically diverse community we serve. They are proof of our commitment to creating a dynamic, inclusive environment that fuels innovation and the gold standard of patient care we strive for.
- Pharm.D. or equivalent degree from an accredited school of pharmacy in the USA.
- Current pharmacist licensure in the State of California.
- BLS certification as outlined in the Pharmacist Responsibilities in Cardiopulmonary Resuscitation(C.P.R.) and Code Blue Procedure: Pharmacy Policy and Procedure
· Strong clinical pharmacy knowledge and experience – min 2 years or equivalent experience or pharmacy residency experience (PGY-1 and/or PGY-2)
· Pharmacy benefit management or managed care experience desired
· Strong project management and data analytical skills. Demonstrates innovative approaches to problem solving
· Excellent verbal and written communication skills
· Demonstrates customer service focus and excellent interpersonal skills
· Ability to organize work effectively, determine priorities, work well independently as well as in a team environment.
- Working Title: Pharmacist - Clinical Prior Authorization
- Department: Pharmacy-Training
- Business Entity: Clinical & Support Services
- City: Los Angeles
- Job Category: Pharmacy
- Job Specialty: Pharmacy
- Position Type: Full-time
- Shift Length: 8 hour shift
- Shift Type: Day
Cedars-Sinai is an EEO employer. Cedars-Sinai does not unlawfully discriminate on the basis of the race, religion, color, national origin, citizenship, ancestry, physical or mental disability, legally protected medical condition (cancer-related or genetic characteristics or any genetic information), marital status, sex, gender, sexual orientation, gender identity, gender expression, pregnancy, age (40 or older), military and/or veteran status or any other basis protected by federal or state law. If you need a reasonable accommodation for any part of the employment process, please contact us by email at Applicant_Accommodation@cshs.org and let us know the nature of your request and your contact information. Requests for accommodation will be considered on a case-by-case basis. Please note that only inquiries concerning a request for reasonable accommodation will be responded to from this email address.
Cedars-Sinai will consider for employment qualified applicants with criminal histories, in accordance with the Los Angeles Fair Chance Initiative for Hiring.
At Cedars-Sinai, we are dedicated to the safety, health and wellbeing of our patients and employees. This includes protecting our patients from communicable diseases, such as influenza (flu). For this reason, we require that all new employees receive a flu vaccine based on the seasonal availability of flu vaccine (typically during September through March each year) as a condition of employment, and annually thereafter as a condition of continued employment.
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