Rhode Island Licensed Clinical Pharmacist

Job Summary

A company is looking for a Pharmacist - Clinical Pharmacist Advisor (Medicare).

Key Responsibilities

• Support Medicare Part D members and providers with pharmacy benefit and coverage determination requests
• Ensure accurate case setup and complete clinical review of Medicare appeals in compliance with CMS guidelines
• Accurately document all Medicare Part D requests and maintain compliance with CMS-mandated timelines

Required Qualifications

• Bachelor's Degree in Pharmacy or Doctor of Pharmacy (PharmD) required
• Active pharmacist license in the state of residence required
• Proven ability to apply clinical judgment and interpret drug compendia resources
• Prior experience in Medicare Part D, clinical review, or pharmacy benefit management preferred