ZipRecruiter

Log In

SPECTRAFORCE
SPECTRAFORCE

61 Spectraforce Technologies Jobs Hiring Near You

Spectraforce Technologies

Clinical Pharmacist 1

Houston, TX · On-site

$113K - $135K/yr

Position Title: Clinical Pharmacist 1 Work Location: Remote Assignment Duration: 3 Months Work Schedule: 9am - 6pm EST No OT Position Summary: * Pharmacy Appeals Department - Dept 247 * Inclusive ...

Spectraforce Technologies

Pharmacist

Fort Worth, TX · On-site

$55.75 - $67/hr

Position Title: Pharmacist Work Location: FTW, TX 76177 or Cary, NC 27513 Assignment Duration: 3 Months Work Schedule: Cary, NC: training M-F 9-6 EST, after training 9-6 EST and 11-8 EST mix. FTW ...

Spectraforce Technologies

Customer Service

Lake Mary, FL · On-site

$14 - $19/hr

Position Title: Customer Service Work Location: Lake Mary FL Assignment Duration: 04+ Months * Nature of Role: Will work in a Call Center environment receiving inbound calls from customers for supply ...

Spectraforce Technologies

Clinical Care Guide (RN)

Tucson, AZ · On-site

$62K - $86K/yr

Position Title: Clinical Care Guide (RN) Work Location: Tucson, AZ 85718 Assignment Duration: Permanent Fulltime Work Arrangement: On-site Required: Electronic Medical Records experience, direct ...

Spectraforce Technologies

Telehealth Nurse

Cary, NC · On-site

Position Title: Telehealth Nurse Work Location: Cary NC 27513 Assignment Duration: 3+ Months Work Schedule: Monday -Friday 9:00 am - 6:00 pm (occasional Saturdays) Work Arrangement: Hybrid-Onsite ...

Spectraforce Technologies

Customer Service Rep III

Atlanta, GA · On-site

$15.50 - $21/hr

Title: Customer Service Representative III Location: Atlanta, GA, 30354 Duration: 12 months Time: Monday - Friday (8am to 5pm) Note: Hybrid Position (4 days onsite and 1 day remote ) Duties: * Answer ...

previous pagenext page

Showing results 41-60

All JobsSpectraforce Technologies Jobs

SPECTRAFORCE Jobs Information

What is it like to work at Spectraforce Technologies?

Spectraforce Technologies appears to be a professional services company that values collaboration and innovation, fostering a dynamic work environment where employees can grow and contribute to the organization's success.

The company's team structure is designed to support a flexible and adaptable approach to project delivery, with a focus on leveraging the skills and expertise of its employees to meet client needs. Spectraforce Technologies' mission is to provide high-quality IT and business solutions that drive business outcomes for its clients.

Working at Spectraforce Technologies may appeal to candidates who are looking for a challenging and rewarding career in the IT and professional services sector, with opportunities for professional development and advancement in a fast-paced and dynamic work environment.

What makes Spectraforce Technologies an attractive place to work?

Spectraforce Technologies is a professional services firm that specializes in IT consulting and staffing, with a strong reputation for delivering high-quality solutions to clients across various industries. The company fosters a collaborative work environment that encourages innovation, teamwork, and professional growth, with opportunities for employees to develop their skills and expertise in a dynamic and supportive setting. By joining Spectraforce Technologies, individuals can contribute to the success of a forward-thinking organization and pursue a career path that offers opportunities for advancement, skill development, and making a meaningful impact in the industry.

What are the most popular titles at Spectraforce Technologies?

What are the most popular cities for Spectraforce Technologies jobs?

What are the most popular states for Spectraforce Technologies jobs?

Clinical Pharmacist 1

Spectraforce Technologies

Houston, TX • On-site

$113K - $135K/yr

Other

Posted 23 days ago

Job description

Position Title: Clinical Pharmacist 1
Work Location: Remote
Assignment Duration: 3 Months
Work Schedule: 9am - 6pm EST No OT

Position Summary:

  • Pharmacy Appeals Department - Dept 247
  • Inclusive team culture, learning environment (not punitive)
  • Pharmacy Ops Dept includes PA and Appeals - no key projects
  • Evaluate redetermination and appeals coverage requests
  • Department growth
  • Increased volume

Typical Day in the Role
* Reviews a completed prior authorization request received from the provider and/or reviews the pharmacy technician's recommended denial, suggested formulary alternatives, comments and attachments for appropriateness.
* Verifies member's ID number and date of birth.
* Verifies member's eligibility in the appropriate health plan eligibility system.
* Records carrier and group number if applicable.
* Checks for previous prior authorization decisions.
* Verifies coverage in member's prescription benefit when necessary.
* Verifies coverage in member's health plan benefit when necessary.
* Evaluates prescription claim history.
* Reviews chart notes and/or lab values.
* Identifies provider specialty when appropriate.
* Applies Medical Policy Criteria to prior authorization requests.
* Evaluates whether request meets criteria for approval.
* Reviews the request using professional clinical judgment on a case by case basis. A pharmacist will review medication requests not addressed by P&T Committee criteria or guidelines, develop and draft criteria for the non-formulary medication requested.
* Researches and contributes drug references and clinical information to facilitate prior authorization review: directly to physicians via fax or phone encounter; or to pharmacy technicians via memo or on a personal level as an educational tool
* Communicates with physicians regarding prior authorization:
o For a non-formulary drug
o Plan benefits, exclusions
o Quantity limits
o Age restrictions
o Formulary alternatives
* Retrieves and collects data through available reporting resources (i.e. Discoverer, IT Department)
* Compiles data for reporting purposes:
o Drug utilization of non-formulary drugs
o Overturned IPS recommended denials
o Audit pharmacy claims greater than $200.00
o Suggest addition or deletion of drugs to/from the formulary
o Updating qty/days or age limit ends
o Support National P&T Committee
o Other tasks which may arise during the performance of any of the above mentioned duties

Qualification & Experience:

Candidate Requirements
Education/Certification
Required: Pharm D.
Preferred: n/a
Licensure
Required: Any US state
Preferred: n/a
  • Years of experience required
  • Disqualifiers
  • Best vs. average
  • Performance indicators

Must haves: At least one year of professional RPh experience
Nice to haves: Some experience working in managed care, understanding of Medicare/Medicaid law
Disqualifiers: n/a
Performance indicators: * Sign 85 - 100 cases daily
  • Top 3 must-have hard skills
  • Level of experience with each
  • Stack-ranked by importance
  • Candidate Review & Selection


1
Self-Motivated/Good Time Management Skills
2
Working Knowledge of Office Suite
3
Goal Oriented

Apply