Arizona or Texas Licensed Clinical Pharmacist

Job Summary

To support medication management, the full-time Prior Authorization Clinical Pharmacist will review and adjudicate prior authorization requests remotely, ensuring compliance with clinical guidelines and formulary standards while collaborating with healthcare professionals.

Key responsibilities

• Review, assess, and adjudicate medication prior authorization requests for medical necessity and clinical appropriateness
• Apply evidence-based clinical guidelines and plan-specific criteria to support authorization decisions
• Collaborate with clinical staff to resolve complex cases and ensure compliance with regulations and quality standards

Required qualifications

• Active and unrestricted pharmacist license in Arizona or Texas in good standing
• Bachelor's Degree in Pharmacy; Doctor of Pharmacy (Pharm.D.) preferred
• At least 2 years of experience as a pharmacist, including Medicaid Prior Authorization support
• Experience with clinical decision-making using evidence-based guidelines
• Knowledge of clinical program components and prescription benefit trends