Licensed Clinical Pharmacist

A company is looking for a Clinical Pharmacist, Utilization Management (Part B Drugs).

Key Responsibilities

Review prior authorization requests for drugs and biologics under Part B benefits

Evaluate appeals of previously denied requests and ensure member understanding of benefits

Support internal clinical and non-clinical staff in understanding policies and procedures

Required Qualifications

Doctorate of Pharmacy degree (PharmD)

Active pharmacist license in at least one state

Minimum of 2 years of utilization management experience or completion of a managed care residency

Willingness to work Monday-Friday 8am to 5pm EST with rotating weekend on-call

Experience with pharmacy-related quality assurance work is preferred