Clinical Pharmacist

IMCS Group; United States; On-site; USD 76,000 - 103,000; Full time

Job summary

IMCS Group seeks a Pharmacy DUR Specialist for a 6-month contract (potential extension), 10:00 to 18:30 EST. You will review 140–160 clinical prior authorizations or coverage determinations each day and define formularies and clinical criteria to guide plan design and programs.

The role emphasizes policy development, quality controls, MTM coordination, and cross‑departmental clinical support. Pharmacy experience in managed care is essential.

Qualifications

• 2+ years of mail order, retail, hospital or managed care pharmacy experience or 1+ year in a pharmacy residency program.

Responsibilities

• Review 140–160 clinical prior authorizations or coverage determinations daily.
• Define and develop standard and custom formularies for assigned plan.
• Develop clinical criteria for medications and recommend plan design changes and clinical programs.
• Provide clinical support to internal departments and address clinical questions.
• Ensure quality controls and initiate opportunities for performance improvement in pharmacy/practice.
• Develop, implement, and maintain policies and procedures for the pharmacy department.
• Coordinate the Medicare MTM program and assist case management with member rounds presentations.

Skills

Pharmacy experience

Job description

Duration:

6 months Contract (Possibility to extend)

Schedule:

10am - 6:30pm EST

Key Responsibilities:

• A typical day consists of reviewing 140 to 160 clinical prior authorizations or coverage determinations
• Define and develop standard and custom formularies for assigned plan.
• Develop clinical criteria for medications, recommend plan design changes, and clinical programs to be initiated
• Provide clinical support to internal departments and address clinical related questions
• Ensure appropriate quality controls and initiates opportunities for performance improvement in pharmacy/practice
• Develop and implement programs designed to impact DUR for both Medicaid and Medicare
• Develop, implement, and maintain policies and procedures for the pharmacy department
• Participate in the coordination of the Medicare MTM program
• Assist case management team with members including clinical rounds presentations

Skills Required:

• 2+ years of mail order, retail, hospital or managed care pharmacy experience or 1+ years of pharmacy residency program experience.