Licensed Clinical Review Pharmacist
Job Summary
Joining a dynamic clinical team, the seasonal Licensed Clinical Review Pharmacist will work remotely to review prior authorization requests, ensure compliance with regulations, and provide support to members and healthcare providers.
Key responsibilities
- Review and make evidence-based decisions on prior authorizations and appeals using clinical guidelines
- Document clinical decisions and maintain records in accordance with regulatory standards
- Respond to clinical inquiries from members, prescribers, and pharmacies with professionalism and empathy
Required qualifications
- Doctor of Pharmacy (PharmD) or Bachelor of Science in Pharmacy (B.S. Pharm) from an ACPE-accredited school
- Active, unrestricted pharmacist license in the state of residence
- Minimum of 2 years of pharmacy practice experience
- General understanding of drug information, clinical guidelines, and utilization management strategies
- Availability to work after hours, weekends, and holidays on a rotating or fixed schedule
Complete Job Description
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