Clinical Pharmacist Advisor - State Licensed
Job Summary
To support Medicare Part D members and providers, the full-time Clinical Pharmacist Advisor - State Licensed will manage case setups, review clinical information, and ensure compliance with Medicare guidelines in a remote environment.
Key responsibilities
- Ensure accurate setup and clinical review of Medicare appeals cases
- Document case reviews and clinical decisions in compliance with Medicare guidelines
- Contact providers to obtain additional clinical details as needed for case decisions
Required qualifications
- Bachelor's degree in pharmacy
- Active pharmacy license in good standing in the state of residence
- Minimum of 2 years working experience as a clinical pharmacist
- Knowledge of Medicare Part D and CMS requirements
- Ability to document case reviews accurately and meet CMS-mandated timelines
Complete Job Description
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