Clinical Pharmacist – Aetna Medicaid Prior Authorization

This is a fully remote position, open to applicants in Arizona, +1 more state.

📋 Description

• Serve as a Clinical Pharmacist for Aetna, providing support for Medicaid Prior Authorization.

• Implement evidence-based clinical guidelines and criteria.

• Leverage formularies and preferred drug lists to inform clinical decision-making.

• Collaborate within a high-output managed care team environment.

• Evaluate medical records and relevant clinical literature.

• Prepare SOAP notes effectively.

• Adhere to the 10:00 am–6:30 pm Arizona-time shift following training.

• Complete an 8-week training program from 8:00 am–4:30 pm Arizona time.

• Be available to work one Saturday every six weeks and on occasional holidays.

⛳️ Requirements

• An active and unrestricted pharmacist license in Arizona and/or Texas is required; the candidate must currently possess one of these licenses.

• Must secure the additional Arizona or Texas pharmacist license within 90 days of employment.

• A minimum of 3 years of experience as a pharmacist is required.

• Experience in clinical decision-making using evidence-based clinical guidelines and criteria is essential.

• Proficiency in utilizing formularies and preferred drug lists is necessary.

• Background in a high-production managed care team environment is preferred.

• A solid understanding of clinical program components, formulary designs, and prescription benefit trends is required.

• A BS in Pharmacy or PharmD is mandatory.

• Experience with Medicaid or Medicare is preferred.

• Prior authorization experience is advantageous.

• Familiarity with reviewing medical records, clinical literature, and preparing SOAP notes is preferred.

• Must be able to work the designated Arizona-time shifts, one Saturday every six weeks, and occasional holidays.

🏝️ Benefits

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

• Comprehensive medical coverage.

• Dental coverage available.

• Vision coverage included.

• Paid time off provided.

• Retirement savings options offered.

• Access to wellness programs.

• Additional resources supporting physical, emotional, and financial well-being, subject to eligibility.

• A comprehensive benefits package for full-time colleagues and their families.