Licensed Coverage Review Pharmacist

Job Summary

A company is looking for a Coverage Review Pharmacist to evaluate prior authorization requests and ensure safe medication use.

Key Responsibilities

• Evaluate and render clinical decisions for medication prior authorization requests
• Ensure compliance with regulatory and internal quality standards
• Collaborate with teams to enhance workflow quality and decision support tools

Required Qualifications

• Doctor of Pharmacy (PharmD) degree from an accredited institution
• Active, unrestricted U.S. pharmacist license in good standing
• 2 years of experience in prior authorization or clinical pharmacy review
• Strong understanding of PBM operations and benefit design workflows
• Proficiency with prior authorization platforms and PBM claims systems