Licensed Clinical Pharmacist Advisor
Job Summary
Supporting Medicare Part D members and providers, the full-time Licensed Clinical Pharmacist Advisor will accurately set up cases, review clinical information, and make pharmacy-related decisions while working remotely during business hours.
Key responsibilities
- Ensure accurate setup of Medicare appeals cases and review clinical information for appropriate decision-making
- Contact providers for additional clinical information and complete documentation for Medicare Part D requests
- Utilize drug compendia resources and follow CMS guidelines to ensure compliance with mandated timelines
Required qualifications
- Bachelor's degree in pharmacy; PharmD preferred
- Active Pharmacist license in good standing in the state of residence
- Minimum of 2 years of experience in Medicare Part D clinical review and decision-making
- Experience in Managed Care, PBM, or pharmacy benefits
- Strong computer literacy, including proficiency in Microsoft Excel and Word
Complete Job Description
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