Clinical Pharmacist: Provider Liaison (Middle TN)

Prime Therapeutics; Helena (MT); On-site; USD 108,000 - 184,000; Full time

Job summary

Prime Therapeutics, a leading PBM, is seeking a Provider Liaison Pharmacist to support clinical and regulatory analysis, formulary governance, and testing for benefit plans. The role focuses on ensuring compliance with federal, CMS, state, and local requirements while supporting drug utilization and claims adjudication systems.

The position requires PharmD or BS Pharmacy, active pharmacist license, and at least 1 year of relevant experience.

Qualifications

• Doctor of Pharmacy (PharmD) or Bachelor of Science Pharmacy Degree.
• 1 year of work experience in clinical, retail, hospital, or managed care.
• Current Pharmacist license to practice in the applicable state(s).

Responsibilities

• Partner with internal stakeholders and clients to develop and maintain project and benefit plan testing scenarios, including utilization management and specialty offerings
• Interpret project requests to determine feasibility, document requirements, and provide technical solutions
• Conduct testing, including test plan creation, test execution, and User Acceptance Testing for quality assurance
• Identify and resolve system issues, perform root-cause analysis, and elevate problems to avoid service disruption
• Ensure benefit plans remain in compliance with all regulatory requirements (federal, CMS, state, local, and pharmacy)
• Develop, maintain, and verify data for drug utilization and claims adjudication systems to support evidence-based benefit coverage decisions
• Support concurrent Drug Utilization Review service messages, table settings, testing and adjudication workflows to ensure accuracy and compliance with established protocols and implementation decisions
• Collaborate with leaders to implement client-requested formulary changes and provide subject- matter expertise to internal and external committees
• Other duties as assigned

Skills

Pharmacist license

Analytical skills

Regulatory compliance

Project management

Education

PharmD or BS Pharmacy

Tools

AS400

Lotus Notes

Excel

Job description

Prime Therapeutics, a leading PBM, is seeking a Provider Liaison Pharmacist to support clinical and regulatory analysis, formulary governance, and testing for benefit plans. The role focuses on ensuring compliance with federal, CMS, state, and local requirements while supporting drug utilization and claims adjudication systems.

The position requires PharmD or BS Pharmacy, active pharmacist license, and at least 1 year of relevant experience.