Pharmacist

Pharmacist Overview

• The Pharmacist role offers a contract-based opportunity to apply clinical expertise remotely, ensuring safe pharmaceutical use and compliance with regulations.
• Collaborate with prescribers and internal teams to provide clinical support and resolve escalations effectively.
• Participate in quality audits, inter-rater reliability testing, and training sessions to enhance professional growth.
• Engage in a structured training program combining self-study and instructor-led sessions.
• Work flexible shifts, including weekends, with options for 10-hour or 8-hour schedules.
• Contribute to a dynamic team environment while adhering to compliance standards and regulations.
• Utilize advanced clinical skills to perform managed care reviews and write clinical criteria.
• Support members and providers by ensuring appropriate pharmaceutical use through clinical expertise.
• Join a remote work environment with residency in approved states, offering flexibility and professional development.

Pharmacist Key Responsibilities & Duties

• Review and make decisions on prior authorization requests for pharmacy benefits.
• Conduct peer-to-peer calls with prescribers to discuss clinical rationale for adverse determinations.
• Participate in clinical quality audits and inter-rater reliability testing to ensure high standards.
• Provide support to internal teams for escalations and pharmacy-related inquiries.
• Apply clinical expertise to ensure safe and appropriate pharmaceutical use by members and providers.
• Comply with all applicable laws, regulations, and organizational policies.
• Engage in structured training programs to enhance clinical and operational skills.
• Collaborate with supervisors and senior pharmacists during interviews and training sessions.
• Perform additional duties as assigned to support organizational objectives.

Pharmacist Job Requirements

• Doctor of Pharmacy (PharmD) degree from an accredited institution.
• Active, unrestricted pharmacist license with willingness to obtain additional state licensure.
• Minimum of 3 years of experience as a licensed pharmacist.
• Preferred experience in clinical review within a managed care setting.
• Board certification such as BCPS or BCOP is highly desirable.
• Residency training or equivalent clinical experience is advantageous.
• Strong clinical skills with experience in applying clinical criteria in reviews.
• Ability to work remotely in approved states with flexible scheduling options.
• Commitment to compliance, quality assurance, and professional development.