New prior authorization pharmacist

[Classy12345]

Besides metrics like cases/hour and feedback from pharmacy technicians, what else do they base your performance evaluation on? I cannot find any sample performance evaluation for PA pharmacists. Anything I should be aware of so I’m not “blind sighted”?

Any really handy resources, references, or things to study up on each night? It’s my first PA job and I really want to show my value and do well. I’m nervous about messing up.

---

Members don't see this ad.

 

[Classy12345]

.

 

[notspecial(ty)]

I PMd you

 

[Whereismynorco]

Besides metrics like cases/hour and feedback from pharmacy technicians, what else do they base your performance evaluation on? I cannot find any sample performance evaluation for PA pharmacists. Anything I should be aware of so I’m not “blind sighted”?

Any really handy resources, references, or things to study up on each night? It’s my first PA job and I really want to show my value and do well. I’m nervous about messing up.

I PMd you

I am interested to know as well.

 

[Green82]

I PMd you

HI. I too have recently started a new job as a prior authorization pharmacist. I am very concerned because of my slow speed. The goal is to complete 5 cases per hour, but I usually hit 2 per hour. I am very detailed and I do have trouble deciding how to word things, which slows me down. I really want to be successful in this role and stand out to my PIC.

I have been searching for other resources aside from the resources provided by my employer, but can hardly find anything. Like Classy 12345, I am specially interested in any handy resources, references, or useful info to know for the job that I can study. Would you be willing to message or email me? My email is [email protected]. I would greatly appreciate your time and advice. I would not be where I am today without the many seasoned pharmacists who have taken time to help me along my way!

 

[notspecial(ty)]

HI. I too have recently started a new job as a prior authorization pharmacist. I am very concerned because of my slow speed. The goal is to complete 5 cases per hour, but I usually hit 2 per hour. I am very detailed and I do have trouble deciding how to word things, which slows me down. I really want to be successful in this role and stand out to my PIC.

I have been searching for other resources aside from the resources provided by my employer, but can hardly find anything. Like Classy 12345, I am specially interested in any handy resources, references, or useful info to know for the job that I can study. Would you be willing to message or email me? My email is [email protected]. I would greatly appreciate your time and advice. I would not be where I am today without the many seasoned pharmacists who have taken time to help me along my way!

Not sure which PBM you work for, but my top 3 tips:

1. Compliance is important. You need to make sure a case gets decisioned in a timely manner. Maybe a case says standard timing but on the fax it actually says urgent on the last page so you need to contact whoever is in charge of reworking cases (if not you) to update it.

2. Follow the guidelines provided by your PBM. This part is the most straight forward. Pt has all criteria? Ok approve. Pt missing just one criteria? Ok deny. But to do this right, you have to make sure it’s even the right PA type. Is the case you’re working on a non formulary case? But you’re using guidelines for step therapy? Ok then you used the wrong info to decision the case.

3. Read the company job aids and SOPs. You don’t remember how to do a quantity limit since training was too much info? Go read the SOP for a quantity limit. I’m sure you can ask your trainers for help but they’d prob want you to learn how to do and find things on your own.


Idk how long you’ve been on the job/training. But from my experience (I’m a permanent PA rph not contract), they expected us to slowly work up to the goal case per hour. Idk if it’s faster or different for a contractor. Some cases take 5 min. Some take longer. I was told we should focus on quality more than quantity. But still try to reach the goal. the supervisor has convos with people who are not on par to help them get on the same page.