Pharmacist Overview • The Pharmacist role offers a contract-based opportunity to apply clinical expertise remotely, ensuring safe pharmaceutical use and compliance with regulations. • Collaborate with prescribers and internal teams to provide clinical support and resolve escalations effectively. • Participate in quality audits, inter-rater reliability testing, and training sessions to enhance professional growth. • Engage in a structured training program combining self-study and instructor-led sessions. • Work flexible shifts, including weekends, with options for 10-hour or 8-hour schedules. • Contribute to a dynamic team environment while adhering to compliance standards and regulations. • Utilize advanced clinical skills to perform managed care reviews and write clinical criteria. • Support members and providers by ensuring appropriate pharmaceutical use through clinical expertise. • Join a remote work environment with residency in approved states, offering flexibility and professional development. Pharmacist Key Responsibilities & Duties • Review and make decisions on prior authorization requests for pharmacy benefits. • Conduct peer-to-peer calls with prescribers to discuss clinical rationale for adverse determinations. • Participate in clinical quality audits and inter-rater reliability testing to ensure high standards. • Provide support to internal teams for escalations and pharmacy-related inquiries. • Apply clinical expertise to ensure safe and appropriate pharmaceutical use by members and providers. • Comply with all applicable laws, regulations, and organizational policies. • Engage in structured training programs to enhance clinical and operational skills. • Collaborate with supervisors and senior pharmacists during interviews and training sessions. • Perform additional duties as assigned to support organizational objectives. Pharmacist Job Requirements • Doctor of Pharmacy (PharmD) degree from an accredited institution. • Active, unrestricted pharmacist license with willingness to obtain additional state licensure. • Minimum of 3 years of experience as a licensed pharmacist. • Preferred experience in clinical review within a managed care setting. • Board certification such as BCPS or BCOP is highly desirable. • Residency training or equivalent clinical experience is advantageous. • Strong clinical skills with experience in applying clinical criteria in reviews. • Ability to work remotely in approved states with flexible scheduling options. • Commitment to compliance, quality assurance, and professional development.