California Licensed Clinical Pharmacist
Job Summary
To support prior authorization processes, the full-time Remote Clinical Pharmacist will conduct clinical reviews, evaluate medical necessity, and communicate coverage determinations while working remotely.
Key responsibilities
- Evaluate and review prior authorization requests based on clinical criteria and plan design
- Consult with healthcare providers and communicate case decisions promptly and accurately
- Manage inbound and outbound calls related to prior authorization inquiries and issues
Required qualifications
- Bachelor's degree in pharmacy
- Active Pharmacist license in the applicable state of practice or residence
- 2+ years of prior authorization or clinical pharmacy review experience
- Experience in PBM, managed care, or specialty pharmacy
- Ability to work one weekend day each week and attend the complete training period
Complete Job Description
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