Clinical Pharmacist I

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

📋 Description

• Assess and provide decisions on Part D coverage determinations and appeal requests.

• Conduct thorough medication reviews over the phone for members participating in the MTM program.

• Engage in pharmacy quality enhancement initiatives that align with Medicare Star Ratings.

• Keep accurate records of all clinical assessments, coverage determinations, and consultations in compliance with CMS deadlines.

⛳️ Requirements

• At least 1 year of experience in a health plan, Pharmacy Benefit Manager (PBM), or managed care pharmacy environment.

• Bachelor's degree in Pharmacy or a related health science discipline.

• A valid and unrestricted Pharmacist license in the relevant state(s).

• Comprehensive knowledge of CMS Medicare Part D coverage determination and appeal procedures.

• Skilled in performing CMR and TMR reviews; knowledgeable about MTM platforms and associated documentation requirements.

🏝️ Benefits

• Health insurance

• Flexible work arrangements

• Opportunities for professional development