Prime Therapeutics

Physician Clinical Reviewer - Rheumatology- REMOTE

Home, USA · Vp

Work authorization required$91k-$154kDetected 83 days ago

CybersecurityPCRResearchLeadershipCommunication

About the role

At Prime Therapeutics (Prime), we are a different kind of PBM, with a purpose beyond profits and a unique ability to connect care for those we serve. Looking for a purpose-driven career? Come build the future of pharmacy with us.
Physician Clinical Reviewer - Rheumatology- REMOTE Job Description

Must be eligible to work in the United States without the need for work visa or residency sponsorship.
Must be able to remain in a stationary position 50% of the time. Must be able to "move or traverse"
Must be able to hear and constantly communicate information and ideas. Must be able to exchange accurate information

Physical Demands
Must be able to remain in a stationary position 50% of the time.
Must be able to "move or traverse"
Must be able to constantly operate a computer and/or other office productivity equipment
Must be able to hear and constantly communicate information and ideas.
Must be able to exchange accurate information
Occasionally required to lift and/or move up to 10 pounds and occasionally lift and/or move up to 25 pounds
Prime Therapeutics LLC is proud to be an equal opportunity and affirmative action employer.

Potential pay for this position ranges from $90.87 - $154.33 based on experience and skills.

To review our Benefits, Incentives and Additional Compensation, visit our Benefits Page and click on the "Benefits at a glance" button for more detail (https://www.primetherapeutics.com/benefits).

Key member of the utilization management team, and provides timely medical review of service requests that do not initially meet the applicable medical necessity guidelines.
Routinely interacts with physicians, leadership and management staff, other Physician Clinical Reviewers (PCR), and health plan membersand staff whenever a physician`s input is needed or required.
Ensures documentation of all communications with medical office staff and/or physician/provider is recorded in a timely and accurate manner.
Assists the Medical Director and/or VP, Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines, and/or system support.
On a requested basis, may function as Medical Director for select health plans or regions, assuming overall accountability for utilization management while working in conjunction with the VP, Medical Director
Education & Experience
Education Level

At Prime Therapeutics (Prime), we are a different kind of PBM, with a purpose beyond profits and a unique ability to connect care for those we serve.

Must be eligible to work in the United States without the need for work visa or residency sponsorship.

This listing is sourced directly from Prime Therapeutics's careers page and normalized into a canonical job model.