State Licensed Clinical Pharmacist

Job Summary

Supporting Medicare Part D members and providers, the full-time State Licensed Clinical Pharmacist will manage case setups, review clinical information, and ensure timely documentation while working remotely during business hours.

Key responsibilities

• Ensure accurate setup of Medicare appeals cases and review clinical information for appropriate decision-making
• Contact providers for additional clinical information and complete clear documentation for Medicare Part D requests
• Utilize drug compendia resources and adhere to CMS guidelines to maintain compliance and productivity standards

Required qualifications

• Bachelor's degree in pharmacy
• Active Pharmacist license in good standing in the state of residence
• Minimum of 2 years of experience in Medicare Part D appeals and clinical review
• Experience with clinical documentation and provider outreach
• Proficiency in navigating multiple computer applications and data entry