Pennsylvania Licensed Clinical Pharmacy Specialist

Job Summary

Supporting the Prior Authorization Team, the full-time Pennsylvania Licensed Clinical Pharmacy Specialist will provide clinical pharmacy expertise in managing pharmacy utilization and the prior authorization process while working remotely during daylight hours.

Key responsibilities:

• Perform clinical reviews of Prior Authorization and other pharmacy utilization management requests in compliance with quality standards
• Critically evaluate pharmacy requests for approval or denial based on clinical criteria and regulatory policies
• Engage in the pharmacy appeals process and respond to inquiries from stakeholders in a timely and professional manner

Required qualifications:

• Bachelor of Science Degree in Pharmacy or Doctor of Pharmacy Degree (Pharm.D.) from an accredited U.S. School of Pharmacy
• Licensure as a registered pharmacist (RPh) in Pennsylvania or eligibility for licensure by examination or reciprocity
• Experience in pharmacy benefit management or managed care preferred
• Strong analytical and organizational skills
• Computer literacy for pharmacy programming and data management