Clinical Staff Pharmacist Remote

@ Prime Therapeutics

About the Clinical Staff Pharmacist Remote Role

Our work matters. At Prime Therapeutics, we help people get the medicine they need to feel better and live well. This commitment fuels our passion and drives every decision.

Job Description

The Clinical Staff Pharmacist is responsible for processing and documenting Utilization Management requests (such as formulary exceptions, prior authorization, step therapy, and quantity limit exceptions) for delegated products and services.

Responsibilities

• Evaluate clinical coverage determination requests including prior authorization and utilization management inquiries.
• Assess denial language and decision appropriateness based on clinical content.
• Consult directly with health care providers on non-formulary and clinical product coverage issues.
• Collaborate with team members to ensure consistency across decisions.
• Perform other duties as assigned.

Minimum Qualifications

• Doctor of Pharmacy (PharmD) or Bachelor of Science in Pharmacy Degree.
• Current pharmacist license in good standing with the State Board of Pharmacy.
• At least 1 year of relevant work experience.
• Must be eligible to work in the United States without visa sponsorship.

Additional & Preferred Qualifications

• Excellent verbal and written communication skills.
• Ability to work both independently and as a team member.
• Managed care experience is preferred.
• Proficiency with Microsoft Office.

Other Information

Every employee must comply with all security responsibilities, legal and regulatory requirements. Reasonable accommodations are available for employees with disabilities. Prime Therapeutics LLC is an equal opportunity employer and a Tobacco-Free Workplace. For compensation details and benefits, please refer to our Benefits Page.

Key skills/competency

• Pharmacy
• Utilization Management
• Formulary Exceptions
• Prior Authorization
• Clinical Evaluation
• Consultation
• Managed Care
• Microsoft Office
• Compliance
• Remote Work