Clinical Review Pharmacist (REMOTE)

Unitas; Town of River Falls (WI); Remote; USD 100,000 - 120,000; Full time

Job summary

Unitas, located in Wisconsin, seeks a Clinical Pharmacist responsible for managing Utilization Management requests and ensuring sound clinical judgment.

The ideal candidate will hold a Doctor of Pharmacy or Bachelor's in Pharmacy and possess a current pharmacist license. Strong communication and decision-making skills are essential to navigate complex clinical scenarios effectively.

This role offers the chance to collaborate with healthcare providers and improve the quality of clinical decisions within the team.

Qualifications

• Doctor of Pharmacy (PharmD) or Bachelor of Science in Pharmacy degree required.
• Current pharmacist license in good standing.
• Confident in making clinical decisions independently.

Responsibilities

• Evaluate and determine client UM requests based on clinical intent.
• Consult with healthcare providers on product coverage issues.
• Collaborate to promote consistency in clinical decisions.

Skills

Clinical decision-making

Pharmacy knowledge

Communication

Task prioritization

Self-starter

Education

Doctor of Pharmacy (PharmD)

Bachelor of Science in Pharmacy

Job description

UNITAS provides clinical staffing and consulting solutions, including contract staff augmentation, permanent talent recruiting, consulting, and clinical coaching. Our extensive experience includes Pharmacy Benefit Management, Long-Term Care, Retail Pharmacy, Hospital, and Leadership, enabling us to connect the best clinical talent with outstanding companies. We know clinicians because we are clinicians!

About the role

• The Clinical Pharmacist is responsible for the processing and documenting of Utilization Management (UM) requests (e.g. prior authorization, step therapy, formulary exceptions) for delegated products and services. The work is detail-oriented, and candidates will be expected to provide sound clinical judgement and communication.
• Positions are available in Medicare and Commercial lines of business.

What you’ll do

• Responsible for the clinical evaluation and determination of client UM requests, which includes consideration of the denial language, as well as the appropriateness of the decision as it pertains to the clinical intent of the individual program criteria.
• Accountable for direct consultation with health care providers concerning non-formulary and clinical product coverage issues.
• Collaborate with team members to promote consistency of clinical decisions across the pharmacist team.
• Other duties as assigned.

Qualifications

• Doctor of Pharmacy (PharmD) or Bachelor of Science in Pharmacy degree.
• Current pharmacist license in good standing at local State Board of Pharmacy.
• Confident in making clinical decisions independently.
• Ability to prioritize tasks and manage multiple projects simultaneously.
• Motivated self-starter who does not require constant direction or feedback to drive results.
• Flexibility to evolve in a dynamic working environment.
• Proficient with learning new computer systems and using multiple monitors.