Medicare Clinical Pharmacist Advisor

SGS Consulting; United States; On-site; USD 90,000 - 120,000; Full time

Job summary

SGS Consulting in the United States is seeking a Clinical Pharmacist Advisor Medicare to support Medicare Part D members and providers with pharmacy benefits, ensuring accurate case setup and timely decisions.

You will review clinical information, perform outreach to providers when needed, and comply with Medicare guidance, compendia, CMS timelines, and quality standards to deliver best-in-class service.

Qualifications

• Bachelor's degree in pharmacy or PharmD. required. Must have an active license in good standing in state of residence.

Responsibilities

• Ensure accuracy of case setup and clinical review of Medicare appeals.
• Provide clear documentation and contact providers to obtain clinical details.
• Adhere to CMS timelines and Medicare guidelines.
• Support continuous improvement through supervisor feedback.

Skills

Clinical review

Provider outreach

Documentation

Medicare guidelines

Education

Bachelor's degree in pharmacy or PharmD

Tools

Drug compendia resources

Job description

SGS Consulting in the United States is seeking a Clinical Pharmacist Advisor Medicare to support Medicare Part D members and providers with pharmacy benefits, ensuring accurate case setup and timely decisions.

You will review clinical information, perform outreach to providers when needed, and comply with Medicare guidance, compendia, CMS timelines, and quality standards to deliver best-in-class service.