Medicare Part D Clinical Pharmacist Advisor

Us Tech Solutions; Rhode Island; On-site; USD 74,000 - 80,000; Full time

Job summary

US Tech Solutions is seeking a Clinical Pharmacist Advisor Medicare in Rhode Island for a 12-month contract. You will support Medicare Part D members and providers, ensuring accurate case setup and timely decisions in line with Medicare guidance and CMS timelines.

The role requires a Pharmacist license, a pharmacy degree, and familiarity with PBM offerings and managed care. Join a leading healthcare firm focused on quality service.

Qualifications

• Pharmacist licensed in the state of residence.
• Experience in managed care or PBM environments preferred.
• Familiarity with Medicare Part D guidelines and timelines.

Responsibilities

• Ensure accuracy of case setup and clinical review for Medicare appeals.
• Review internal notes and requests, obtaining clinical details as needed.
• Document clearly and contact providers to obtain information for decisions.
• Adhere to CMS timelines and departmental quality standards.
• Engage in development discussions and respond to supervisor feedback.

Skills

Clinical Pharmacist

Prior Authorization

PA Request

Medicare Part D

Pharmacy Benefit management

PBM

Managed care

Education

Bachelor's degree in pharmacy or Pharm D.

Job description

US Tech Solutions is seeking a Clinical Pharmacist Advisor Medicare in Rhode Island for a 12-month contract. You will support Medicare Part D members and providers, ensuring accurate case setup and timely decisions in line with Medicare guidance and CMS timelines.

The role requires a Pharmacist license, a pharmacy degree, and familiarity with PBM offerings and managed care. Join a leading healthcare firm focused on quality service.