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Clinical Pharmacist
Remote
Contract/Temp
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Description
Clinical Pharmacist
Job Summary
Key Responsibilities
- Review prior authorization requests and make drug coverage determinations based on member benefits and established clinical criteria.
- Review guidelines for prior authorization and non-formulary medications to support pharmacy benefit design and Pharmacy and Therapeutics Committee activities.
- Track utilization review cases and ensure compliance with established review requirements and timelines.
- Analyze and summarize daily utilization review data and prepare statistics for corporate compliance reporting.
- Provide clinical guidance and support to assigned pharmacy technicians.
- Apply knowledge of drug coding systems, including NDC, GCN, GPI, and USC, and NCPDP claims adjudication systems.
- Evaluate quality controls and identify opportunities for performance improvement in pharmacy practices.
- Research drug information and disease states to maintain current clinical knowledge and support accurate prior authorization reviews.
Required Qualifications
- Bachelor’s degree or advanced degree in Pharmacy.
- Minimum of 3 years of experience in a related field.
- Current pharmacist license in the applicable state(s).
- Knowledge of prior authorization reviews, pharmacy benefits, and medication coverage criteria.
- Familiarity with drug coding systems and pharmacy claims adjudication.
- Strong analytical, communication, and documentation skills.
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Clinical Pharmacist
Copy job link
Email
LinkedIn
Whatsapp
X (Formerly Twitter)
Facebook
Remote
Contract/Temp
Description
Clinical Pharmacist
Job Summary
Key Responsibilities
- Review prior authorization requests and make drug coverage determinations based on member benefits and established clinical criteria.
- Review guidelines for prior authorization and non-formulary medications to support pharmacy benefit design and Pharmacy and Therapeutics Committee activities.
- Track utilization review cases and ensure compliance with established review requirements and timelines.
- Analyze and summarize daily utilization review data and prepare statistics for corporate compliance reporting.
- Provide clinical guidance and support to assigned pharmacy technicians.
- Apply knowledge of drug coding systems, including NDC, GCN, GPI, and USC, and NCPDP claims adjudication systems.
- Evaluate quality controls and identify opportunities for performance improvement in pharmacy practices.
- Research drug information and disease states to maintain current clinical knowledge and support accurate prior authorization reviews.
Required Qualifications
- Bachelor’s degree or advanced degree in Pharmacy.
- Minimum of 3 years of experience in a related field.
- Current pharmacist license in the applicable state(s).
- Knowledge of prior authorization reviews, pharmacy benefits, and medication coverage criteria.
- Familiarity with drug coding systems and pharmacy claims adjudication.
- Strong analytical, communication, and documentation skills.