Clinical Administrative Pharmacist

This is a fully remote position, open to applicants in Tennessee.

📋 Description

• Collaborate with internal stakeholders and clients to create and uphold testing scenarios for project and benefit plans, encompassing utilization management and specialty offerings.

• Analyze project requests to assess feasibility, document requirements, and deliver technical solutions.

• Execute testing, which includes the development of test plans, test execution, and User Acceptance Testing for quality assurance purposes.

• Detect and resolve system issues, conduct root-cause analysis, and escalate problems to prevent service disruptions.

• Ensure that benefit plans comply with all relevant regulatory standards (federal, CMS, state, local, and pharmacy).

• Create, maintain, and verify data for drug utilization and claims adjudication systems to facilitate evidence-based benefit coverage decisions.

• Assist with concurrent Drug Utilization Review service messages, table settings, testing, and adjudication workflows to ensure precision and adherence to established protocols and implementation strategies.

• Work alongside leaders to enact client-requested formulary modifications and offer subject-matter expertise to both internal and external committees.

• Perform additional duties as assigned.

⛳️ Requirements

• Doctor of Pharmacy (PharmD) or Bachelor of Science in Pharmacy degree.

• Minimum of 1 year of professional experience in clinical, retail, hospital, or managed care settings.

• Current Pharmacist license valid for practice in the relevant state(s).

• Must be eligible to work in the United States without requiring a work visa or residency sponsorship.

• Familiarity with AS400, queries, and Lotus Notes.

• Excellent analytical and problem-solving abilities with a keen eye for detail and quality.

• Capability to juggle multiple projects simultaneously under pressure while adhering to strict deadlines.

• Proficient in developing and enhancing process efficiencies.

• Strong teamwork skills and the ability to thrive in a collaborative environment.

• Proficient in Microsoft Excel and Word.

🏝️ Benefits

• Benefits, incentives, and additional compensation (details available on the employer's Benefits Page).

• Equal opportunity and affirmative action employment.

• Reasonable accommodations for employees with disabilities.

• Tobacco-free workplace.