Remote Medicare Pharmacist

Job Summary

Supporting Medicare members, the full-time Remote Medicare Pharmacist will review pharmacy benefit requests, ensure accurate case documentation, and apply Medicare guidelines while working in a fully remote environment.

Key responsibilities

• Review and process Medicare pharmacy benefit requests and appeals
• Conduct outreach to providers and prescribers for additional clinical information as needed
• Ensure compliance with CMS regulations, quality standards, and productivity expectations

Required qualifications

• Bachelor's Degree in Pharmacy (B.Pharm) or Doctor of Pharmacy (Pharm.D.)
• Active Registered Pharmacist license in good standing in the state of residence
• Minimum of 2 years of experience in managed care or related healthcare pharmacy environment
• Strong analytical skills and attention to detail in reviewing clinical documentation
• Experience with data entry and navigating multiple systems simultaneously