Pennsylvania Licensed Pharmacist

Job Summary

Working from home in Pennsylvania, the full-time salaried Pennsylvania Licensed Pharmacist will manage pharmacy benefits, perform medical necessity reviews, and develop clinical criteria while ensuring high-quality member care and satisfaction.

Key responsibilities

• Act as a liaison between the Health Plan and customers regarding pharmaceutical benefits
• Perform extensive literature reviews and develop clinical criteria for new and existing pharmaceuticals
• Support internal operations with information on pharmacy and medical drug benefits, formulary details, and prior authorizations

Required qualifications

• Bachelor's Degree in Pharmacy (preferred)
• Active and unrestricted Pennsylvania Pharmacist license within 90 days
• Experience in pharmacy benefit management and clinical operations
• Knowledge of formulary management and prior authorization processes
• Ability to perform medical necessity reviews according to specified timelines