Rhode Island Licensed Clinical Pharmacist

Job Summary

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

Key responsibilities

• Review internal notes and fax requests to ensure accuracy in case setup and clinical decision-making for Medicare appeals
• Conduct outreach to providers for additional clinical information as needed and document all interactions clearly and concisely
• Adhere to Medicare guidelines and departmental productivity standards while participating in continuous improvement discussions with supervisors

Required qualifications

• Bachelor's degree in pharmacy or Pharm D
• Active Rhode Island pharmacist license in good standing
• Experience in a Managed Care/PBM environment is preferred
• Proficiency in data entry and navigating multiple computer applications
• Availability for training Monday through Friday from 9am to 5:30pm EST for the first 8 weeks