Clinical Staff Pharmacist - Coverage Review - Remote
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The Cigna Group
📍 Bloomfield, CT, United States
Job Description
**Clinical Staff Pharmacist – Express Scripts Coverage Review Department (CRD)**
**Training Schedule: 9AM-5:30PM EST for approximately 4 weeks**
**Schedule after Training: 9:30AM-6PM local time zone**
**Role Summary** :
Utilization management pharmacists are responsible for reviewing each plans policy to determine if coverage can be granted for a medication. Provide clinical support and oversight for all utilization management (UM) activities. Responsible for finalizing all denials of clinical prior authorization requests.
**Responsibilities** :
+ Supports the Coverage Review Department (CRD) as a clinical resource for drug therapy questions
+ Applies critical thinking to achieve proper clinical decisions when performing clinical reviews
+ Utilizes multiple systems and other clinical resources to achieve proper decisions in Utilization Management reviews
+ Works and maneuvers within a queue system that prioritizes clinical ...
**Training Schedule: 9AM-5:30PM EST for approximately 4 weeks**
**Schedule after Training: 9:30AM-6PM local time zone**
**Role Summary** :
Utilization management pharmacists are responsible for reviewing each plans policy to determine if coverage can be granted for a medication. Provide clinical support and oversight for all utilization management (UM) activities. Responsible for finalizing all denials of clinical prior authorization requests.
**Responsibilities** :
+ Supports the Coverage Review Department (CRD) as a clinical resource for drug therapy questions
+ Applies critical thinking to achieve proper clinical decisions when performing clinical reviews
+ Utilizes multiple systems and other clinical resources to achieve proper decisions in Utilization Management reviews
+ Works and maneuvers within a queue system that prioritizes clinical ...