Senior Clinical Pharmacist

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

📋 Description

• Develop both standard and customized formularies for specialized or complex medications.

• Create clinical criteria for medication assessments and suggest modifications to plan designs.

• Oversee and evaluate prior authorization and appeal requests.

• Establish clinical edits to process claims and improve drug utilization.

• Analyze trends in pharmacy costs and care utilization.

• Coordinate guidelines, protocols, client reports, and regulatory submissions.

• Design and implement medication therapy management programs.

• Assess program effectiveness and initiate enhancements as needed.

• Ensure quality control measures and identify opportunities for performance improvement.

• Conduct research on drug information relevant to prior authorization assessments.

• Offer clinical advice to departments and respond to clinical inquiries.

• Assist in the evaluation, development, and growth of clinical pharmacy initiatives.

• Analyze pharmacy data and trends to enhance member outcomes.

• Cultivate strategic relationships that support organizational goals.

• Perform additional duties as required.

⛳️ Requirements

• Bachelor’s degree or higher (Pharm.D., M.S.) in pharmacy.

• Minimum of 4 years of experience in mail order, retail, hospital, managed care pharmacy, or completion of a pharmacy residency program.

• Valid pharmacist license in the current state with no restrictions.

• May need to acquire additional state licensure based on business requirements.

• Comprehensive understanding of drug information and various disease states.

• Capability to support clinical program outcome evaluations across diverse patient populations.

• Proficiency in developing and assessing clinical programs across Commercial, Medicaid, Medicare Part D, and the Health Insurance Marketplace.

• Adherence to all policies and standards.

🏝️ Benefits

• Health insurance.

• 401K.

• Stock purchase plans.

• Tuition reimbursement.

• Paid time off in addition to holidays.

• Flexible working options including remote, hybrid, field, or office schedules.

• Other forms of incentives may be part of the total compensation package.

• Equal opportunity employer dedicated to diversity.