Pharmacist – Clinical Pharmacist Advisor Medicare

Job Description

Job Summary:

• The Prior Authorization Pharmacist is responsible for reviewing and evaluating medication prior authorization requests to ensure appropriate, safe, and cost-effective therapy in accordance with clinical guidelines, regulatory requirements, and organizational policies.
• This role applies clinical judgement to support optimal patient outcomes while balancing utilization management objectives.

Required Experience:

• Active and unrestricted Client or TX pharmacist license.
• Experience with clinical decision-making while applying evidence based clinical guidelines/criteria; utilizing formularies/preferred drug lists.
• Experience working in a high production team environment.
• 3+ years experience working as a pharmacist.
• Knowledge of clinical program components, formulary designs, and prescription benefit trends.

Required Education:

• High School Diploma or GED required.
• Bachelor’s degree in pharmacy or Pharm D.
• Also required with at least two years experience as a pharmacist.
• Must have an active license in good standing.