Rhode Island Licensed Clinical Pharmacist

Job Summary

To support Medicare Part D members and providers, the full-time salaried Rhode Island Licensed Clinical Pharmacist will ensure accurate case setup and clinical review of Medicare appeals cases while working remotely and adhering to Medicare guidelines.

Key responsibilities

• Review and document clinical information for Medicare appeals, ensuring compliance with guidelines and timelines
• Perform outreach to providers for additional information necessary for case decisions
• Participate in development discussions and apply clinical judgment utilizing drug compendia resources

Required qualifications

• Bachelor's degree in pharmacy or Pharm D
• Active Rhode Island pharmacist license in good standing
• Experience in a Managed Care or PBM environment (preferred)
• Computer literacy with knowledge of Excel, Word, Access, and PowerPoint
• Ability to work independently in a productivity-driven role with a focus on data entry