Clinical Pharmacist - Medicaid/Medicare
Job Summary
To support the Medicare and Medicaid prior authorization process, the full-time Clinical Pharmacist - Medicaid/Medicare will conduct clinical reviews, determine coverage decisions, and provide recommendations to improve medication regimens while working remotely.
Key responsibilities
- Conduct clinical reviews and determine Medicare/Medicaid coverage determinations and medical reviews
- Monitor the quality and efficiency of the prior authorization process, including communications with prescribers and members
- Provide clinical recommendations to physicians to enhance medication regimens as needed
Required qualifications
- Doctor of Pharmacy (Pharm.D.)
- Active pharmacist license in good standing in the state of residence
- At least 2 years of experience working as a pharmacist, with managed care experience in Medicaid and Medicare
- Proficiency in Microsoft Excel, Word, Outlook, and SharePoint
- At least 1 year of clinical pharmacy experience
Complete Job Description
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