Caleb Lynch Email & Phone Number

Redondo Beach, California, United States

Reviewed coverage determinations and appeals in a timely, compliant, and accurate manner for Medicaid, Medicare, and health insurance marketplace (HIM) plans. Gathered complex clinical information and coverage policy and criteria information, and worked within regulatory guidelines to ensure accurate decision making on all cases. Provided clinical pharmacy expertise to the development, implementation, and management of the pharmacy benefit. Completed peer-to-peer, secondary reviews with provider offices to ensure the most accurate decision had been made. Served as a drug information and formulary resource for questions from technicians and other pharmacists. Organized workload, set priorities, and efficiently complete case assignments while complying with department program