Clinical Pharmacy Advisor – Formulary & PA Strategy

nirvanaHealth, LLC; Tampa (FL); On-site; USD 100,000 - 110,000; Full time

Job summary

nirvanaHealth, anRxAdvance Corp. portfolio, seeks a Clinical Advisor in Southborough, MA, to support drug-related prior authorization and payer guidelines.

The role collaborates with pharmacy technicians and pharmacists in Pharmacy Operations to optimize PA reviews, automation, and policy, leveraging evidence-based standards. The ideal candidate has pharmacy acumen, PA expertise, formulary experience, and familiarity with Medicare/Medicaid processes.

Qualifications

• Bachelor’s degree in pharmacy required.
• PharmD degree preferred.
• 1 year managed care experience preferred.

Responsibilities

• Serve as SME in formulary development and clinical programs.
• Coordinate PA operations, reviews, and automation.
• Conduct clinical reviews for PA, Step Therapy, and quantity limits.
• Prepare analytics and reports on PA utilization and outcomes.

Skills

Pharmacy acumen

PA knowledge

Formulary development

Clinical reviews

Medicare/Medicaid knowledge

Evidence-based guidelines

Education

Bachelor’s degree in pharmacy

PharmD preferred

Managed Care or Clinical Residency experience

Tools

Micromedex

Lexicomp

Clinical Pharmacology

Job description

nirvanaHealth, anRxAdvance Corp. portfolio, seeks a Clinical Advisor in Southborough, MA, to support drug-related prior authorization and payer guidelines.

The role collaborates with pharmacy technicians and pharmacists in Pharmacy Operations to optimize PA reviews, automation, and policy, leveraging evidence-based standards. The ideal candidate has pharmacy acumen, PA expertise, formulary experience, and familiarity with Medicare/Medicaid processes.