Licensed Pharmacist Content Analyst

Job Summary

To support the clinical operations and content team, the full-time Licensed Pharmacist Content Analyst will conduct research, ensure quality assurance, and maintain D&B policies while providing coding expertise and mentoring new team members in a remote work environment.

Key responsibilities

• Provide coding and industry expertise for creating and maintaining clinical coding edits
• Write business logic for new rules and enhancements based on industry references
• Review and update D&B policies to ensure an accurate medical policy library

Required qualifications

• Active professional license as a Pharmacist (BSPharm or PharmD)
• 5+ years of experience as a pharmacist, with at least three years in a specialty, clinical, or bedside setting
• Experience in medical policy or prior authorization in a health plan setting preferred
• Familiarity with claims payment and reimbursement methodologies
• Professional certification (AHIMA or AAPC) preferred or willingness to obtain within one year