Clinical Pharmacist – Aetna Medicaid Prior Authorization

This is a fully remote position, open to applicants in Arizona, +8 more states.

📋 Description

• Provide support for Medicaid Prior Authorization as a Clinical Pharmacist at Aetna

• Implement evidence-based clinical guidelines and criteria in decision-making processes

• Utilize formularies and preferred drug lists effectively

• Operate within a high-output remote team setting

• Evaluate medical records and clinical literature

• Prepare SOAP notes

• Adhere to the 10:30 am–7:00 pm CST shift following training

• Complete training on the 10:00 am–6:30 pm CST schedule

• Participate in one Saturday shift every 4–6 weeks and work on occasional holidays

⛳️ Requirements

• Possession of an active and unrestricted pharmacist license in TX and/or AZ

• New hires must secure the secondary license (AZ or TX) within 90 days of employment

• Proven experience in clinical decision-making while applying evidence-based guidelines/criteria

• Experience with formularies and preferred drug lists

• Background in a high-production, remote team environment

• A minimum of 3 years of experience as a pharmacist or completion of a PGY1 managed care residency, including prior authorization experience

• Solid understanding of clinical program elements, formulary designs, and prescription benefit trends

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

• Eligible candidates must currently hold active, unrestricted TX or AZ pharmacist licensure within the United States

🏝️ Benefits

• Medical coverage

• Dental coverage

• Vision coverage

• Paid time off

• Retirement savings options

• Wellness programs

• Additional resources supporting physical, emotional, and financial well-being

• CVS Health bonus, commission, or short-term incentive program in addition to the base salary range