Texas Licensed Clinical Pharmacist

Job Summary

To support Medicare members and providers with pharmacy benefit requests, the fully remote Clinical Pharmacist Advisor - Medicare Part D will review and process pharmacy benefit and appeals requests while ensuring compliance with Medicare guidelines and maintaining productivity standards.

Key Responsibilities

• Accurately set up and process Medicare Part D cases and appeals
• Thoroughly review internal notes, fax requests, and clinical documentation for relevant information
• Apply clinical judgment and pharmacy knowledge to evaluate clinical information and make decisions in accordance with CMS guidelines

Required Qualifications

• Bachelor's degree in Pharmacy or PharmD required
• Active Pharmacist/RPh license in good standing in the state of residence
• Strong clinical judgment and pharmacy knowledge
• Ability to work independently in a productivity-driven environment
• Proficiency with Microsoft Word and Excel