California Licensed Clinical Pharmacist

Job Summary

A company is looking for a Clinical Pharmacist Advisor (Medicare Part D) to work remotely.

Key Responsibilities

• Review and evaluate Medicare Part D prior authorization requests and appeals
• Accurately set up and document cases within internal systems
• Ensure compliance with CMS regulations, timelines, and internal quality standards

Required Qualifications

• Active Pharmacist license in good standing in state of residence
• PharmD or Bachelor's degree in Pharmacy
• Prior experience in PBM, Managed Care, or Health Plan environment
• Direct experience with Prior Authorization and/or coverage determination reviews
• Ability to work independently in a remote, productivity-driven role