Pharmacist

Pharmacist – Clinical Pharmacist Advisor, Medicare
Job Duration: 12 Months – Possible Extension
Location: Remote
Shift:
• Monday–Friday: 7:00 AM–8:00 PM EST
• Saturday–Sunday: 7:00 AM–4:30 PM EST
Position Summary
The Clinical Pharmacist Advisor – Medicare will support Medicare Part D members and providers with pharmacy benefit-related requests. The pharmacist will review clinical information, accurately set up member cases, conduct provider outreach when additional information is required, and make decisions in accordance with applicable compendia, Medicare guidelines, and required timelines.
This role involves reviewing and documenting Medicare Part D requests accurately and efficiently while ensuring compliance with Medicare requirements and delivering a high-quality member and provider experience.
Key Responsibilities
• Review and process Medicare Part D pharmacy benefit requests.
• Evaluate clinical information to support accurate decision-making.
• Conduct outreach to providers when additional clinical information is needed.
• Ensure decisions comply with Medicare guidelines, compendia, and required timelines.
• Complete accurate and timely documentation for all cases.
• Support members and providers with pharmacy benefit-related inquiries.
Required Qualifications
• Bachelor’s degree in Pharmacy or Pharm.D.
• Active Registered Pharmacist (RPh) license in the state of residence, in good standing.
• Strong computer literacy with proficiency in Microsoft Word and Excel.
• Ability to work a set rotation covering business hours between 7:00 AM and 8:00 PM EST.
Preferred Qualifications
• Previous experience in a Managed Care or PBM environment.
• Knowledge of Microsoft Access, PowerPoint, and Visio.
• Experience with Medicare Part D processes and requirements.

Work arrangement
Yes