Clinical Pharmacist- REMOTE
Job Posting Title
Clinical Pharmacist- REMOTE
Job Description
The Clinical Staff Pharmacist is responsible for the processing and documenting of Utilization Management requests (e.g. formulary exceptions, prior authorization, step therapy, quantity limit exceptions) for delegated products and services.
Responsibilities
- Process the clinical evaluation for coverage determination requests for prior authorization or other utilization management programs, including quantity limits, step therapy, formulary exception and tier exception; consider denial language and appropriateness of the decision as it pertains to the clinical content of the case and the intent of the individual client’s pre-approved criteria.
- Consult directly with healthcare providers to address non-formulary and clinical product coverage issues.
- Collaborate with team members to ensure consistent decision-making across the pharmacist team.
- Respond to medication-related inquiries via phone, providing accurate information to patients, providers, and clinics regarding medications, formulary options, and coverage questions.
- Other duties as assigned.
Minimum Qualifications
- Doctor of Pharmacy (PharmD) or Bachelor of Science Pharmacy Degree.
- 1 year of work experience in clinical, retail, hospital, or managed care.
- Current pharmacist license in good standing with the State Board of Pharmacy.
- Must be eligible to work in the United States without the need for a work visa or residency sponsorship.
Additional Qualifications
- Strong verbal and written communication skills.
- Ability to work efficiently with computers and digital tools.
Preferred Qualifications
- Managed care experience.
Potential pay for this position ranges from $51.92 to $88.46 per hour based on experience and skills.
Benefits, incentives and additional compensation can be reviewed on our Benefits Page at
Prime Therapeutics LLC is an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sex (including pregnancy), national origin, disability, age, veteran status, or any other legally protected class under federal, state, or local law. We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law. Prime Therapeutics LLC is a Tobacco-Free Workplace employer. If you are an applicant with a disability and need a reasonable accommodation for any part of the employment process, please contact Human Resources at 1.866.469.1257 or email [email protected].
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