Clinical Pharmacist Overview • The Clinical Pharmacist role involves reviewing prior authorization requests for drug products based on member benefits and coverage criteria. • Collaborate remotely in a contract position, offering flexibility and potential for extension or conversion. • Utilize your expertise in drug coding systems and claims adjudication processes to ensure compliance and quality. • Provide clinical guidance to pharmacy technicians and contribute to performance improvement initiatives. • Engage in research to maintain updated drug knowledge and disease state understanding. • Support Pharmacy and Therapeutics Committee functions and pharmacy benefit design through guideline reviews. • Track compliance of review cases and report utilization review statistics to corporate compliance committees. • This role is ideal for mid-level professionals seeking impactful contributions in clinical pharmacy. Clinical Pharmacist Key Responsibilities & Duties • Review prior authorization requests and determine drug product eligibility based on coverage criteria. • Report utilization review statistics to corporate compliance committees for regulatory adherence. • Summarize daily utilization review data and track compliance of review cases. • Provide clinical guidance and support to pharmacy technicians in their daily operations. • Evaluate quality controls and implement performance improvement opportunities in pharmacy practices. • Research drug information to maintain updated knowledge for prior authorization reviews. • Review guideline criteria for non-formulary drugs and support pharmacy benefit design. • Ensure compliance with drug coding systems and claims adjudication processes. Clinical Pharmacist Job Requirements • Doctor of Pharmacy (PharmD) degree is required for this position. • Minimum of 3 years of experience in a related field, with 5 years preferred. • Current state pharmacy license is mandatory for eligibility. • Proficiency in drug coding systems such as NDC, GCN, GPI, and USC. • Experience with NCPDP claims adjudication systems and prior authorization processes. • Strong analytical skills for summarizing utilization review data and compliance tracking. • Ability to provide clinical guidance and support to pharmacy technicians effectively. • Knowledge of pharmacy benefit design and guideline criteria for non-formulary drugs.