Perform duties to assist in all clinical functions of the prior authorization required to access drug benefits. Facilitate efforts in the review of clinical documentation and appropriate drug selection to aid in procurement of drug authorizations, working within the limits of standard or accepted practice. Demonstrate the company's core values of respect, honesty, integrity, diversity, inclusion, and safety.From one tiny Cincinnati grocery store more than a century ago, we've grown into what today is the nation's largest grocer with nearly 2,800 stores in 35 states operating under 28 different names. As America's grocer, we take pride in bringing diverse teams with a passion for food and people together with one common purpose: To Feed the Human Spirit. With a history of innovation, we work tirelessly to create amazing experiences for our customers, communities AND each other, with food at the heart of it all.

Here, people matter. That's why we strive to provide the ingredients you need to create your own recipe for success at work and in life. We help feed your future by providing the value and care you need to grow. If you're caring, purpose-driven and hungry to learn, your potential is unlimited.

Whether you're seeking a part-time position or a new career path, we've got a fresh opportunity for you. Apply today to become part of our Kroger family! Minimum
- Bachelor's Degree
- High School Diploma or GED
- 1 year experience as a pharmacist
- Strong organization and critical thinking skills as well as attention to detail
- Highly effective communicator with superior listening, understanding, speaking, writing and counseling skills in English
- Proven ability to model high level customer service resulting in improved customer satisfaction and enduring business relationships with patients, prescribers and pharmacy associates
- Demonstrated excellence in attention to detail and the ability to successfully manage multiple priorities with critical focus on accuracy and safety
- Excellent data management software skills with demonstrated adaptability to internal systems
- Demonstrated ability to manage a range of priorities and meet time commitments
- Excellent knowledge of insurance benefit investigation process and techniques

Desired
- Doctorate Degree- Maintain clinical accuracy of prior authorizations with appropriate prescriber; initiate requests, track progress, and expedite responses from insurance carriers and other payers, and maintain contact with customers to keep them continuously informed
- Facilitate efforts in the review of clinical documentation and third party payor criteria to ensure the quality and accuracy of prior authorization submissions
- Communicate with prescribers for clarification or additional information required to complete clinical content of prior authorizations.
- Facilitate appeals process between the patient, physician and insurance company; compose clinical appeals letters based off of specific denial reason and patient's clinical presentation and coordinate appointment of representative document
- Facilitate resolution of drug coverage issues and pro-actively address, research, and resolve issues while maintaining accurate and complete documentation of all inquiries for continuous improvement
- Provide counsel to patients regarding the safe use of medications and ensure that pharmacy services are provided in compliance with regulatory, policy and procedure requirements
- Document case activity, communications and correspondence in computer system to ensure completeness and accuracy of patient contact records
- Ensure that work activities are conducted in compliance with regulatory requirements and the organization s defined standards and procedures, and in a manner that provides the best available level of service and quality
- Perform or assist with any operations, as required to maintain workflow and to meet business needs
- Perform other related duties as assigned
- Must be able to perform the essential job functions of this position with or without reasonable accommodation