Clinical Pharmacist Advisor

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

📋 Description

• Perform clinical evaluations of medication therapy and assess prior authorization requests utilizing PDL criteria.

• Facilitate discussions with providers through peer-to-peer interactions concerning prior authorization outcomes.

• Collaborate with prescribers and internal teams to conduct clinical consultations and implement targeted interventions.

• Assist call center operations by offering clinical insights and aiding in communications with providers and members.

• Act as a subject matter expert for pharmacy-related inquiries throughout the organization.

• Participate in initiatives aimed at quality improvement and program enhancements.

• Maintain clinical proficiency and work with cross-functional teams to promote pharmacy best practices.

• Provide feedback on drug utilization reviews and formulary management processes.

• Aid in operations for the Medicaid Drug Rebate Program and support state pharmacy audits.

• Deliver training sessions to pharmacy providers and assist with reporting and administrative tasks.

⛳️ Requirements

• Must be a Registered Pharmacist with the appropriate State Licensure.

• PharmD (preferred) or a Bachelor of Pharmacy degree is required.

• A minimum of 5 years of experience in a pharmacy environment or within a pharmacy benefit management system.

• Familiarity with Medicaid at both state and federal levels.

• Understanding of pharmacy-related elements associated with Medicaid.

• Proficient knowledge of HIPAA regulations and compliance requirements.

🏝️ Benefits

• Generous, flexible vacation policy.

• 401(k) employer matching.

• Comprehensive health benefits.

• Educational assistance.

• Leadership and technical development academies.