LTC Clinical Pharmacy Specialist — ATI & Claims (Remote)

Clarest Health OHIO, LLC; Troy (OH); Hybrid; USD 110,000 - 115,000; Full time

Benefits offered by this job

Medical, dental & vision insurance

Paid time off

Telemedicine

401k with company match

Open to new grads

Job summary

Remedi SeniorCare, a division of Clarest Health, is seeking a Clinical Service Center Pharmacist to support day-to-day operations in LTC pharmacy. You will review rejected claims, recommend clinically appropriate formulary alternatives, and oversee ATI recommendations.

You will work with the Director and CSC team to ensure regulatory compliance, quality, and service goals, while delivering exceptional patient-focused care across the LTC network.

Qualifications

• PharmD required.
• Eligible for pharmacist licensure and actively working toward licensure in Ohio.
• License must be in good standing.

Responsibilities

• Oversee clinical claim rejection activity.
• Recommend clinically comparable formulary alternatives.
• Review and approve documentation for prior authorization submissions.
• Guide CSC Technicians on actions with insurance plans and customers to resolve rejected claims.
• Collaborate with LTC departments to achieve daily volume, quality and service goals.
• Communicate with customers, insurers and internal staff to resolve rejected clinical claims.

Skills

Attention to detail

Clinical knowledge

Problem solving

Technical systems proficiency

Communication

Education

PharmD

Job description

Remedi SeniorCare, a division of Clarest Health, is seeking a Clinical Service Center Pharmacist to support day-to-day operations in LTC pharmacy. You will review rejected claims, recommend clinically appropriate formulary alternatives, and oversee ATI recommendations.

You will work with the Director and CSC team to ensure regulatory compliance, quality, and service goals, while delivering exceptional patient-focused care across the LTC network.