Policy Clinical Pharmacist/Oncology exp required - REMOTE

Lensa; Austin (TX); Remote; USD 108,000 - 184,000; Full time

Job summary

A leading healthcare company is seeking a Policy Clinical Pharmacist with oncology experience for a remote role. The successful candidate will create and update medical necessity criteria, collaborate with clinical teams, and ensure compliance with policies. Applicants should have a PharmD or BS in Pharmacy, a current pharmacist license, and at least one year of relevant experience. Strong interpersonal and organizational skills are essential.

Qualifications

• At least 1 year of pharmacy, managed care, or pharmaceutical industry experience.
• Current pharmacist license in good standing in the state of employment.

Responsibilities

• Develop and maintain evidence-based clinical criteria.
• Participate in clinical committees and respond to client inquiries.
• Support clinical algorithm development and quality improvement efforts.

Skills

Interpersonal skills

Organizational skills

Communication skills

Data interpretation

Team-oriented mindset

Education

Doctor of Pharmacy (PharmD)

Bachelor of Science in Pharmacy

Job description

Policy Clinical Pharmacist/Oncology exp required - REMOTE

This job description provides a comprehensive overview of the role, responsibilities, qualifications, and company information. However, the formatting can be improved for better readability, and some repetitive or irrelevant content should be streamlined. The core information about the role, responsibilities, and minimum requirements is present and relevant.

To enhance clarity and professionalism, I will remove duplicate headers, unnecessary promotional content, and organize the responsibilities and qualifications more clearly, while maintaining all essential information.

Below is the refined version:

Policy Clinical Pharmacist/Oncology exp required - REMOTE

Job Description: Creates and updates specialty medical necessity criteria based on clinical evidence (e.g., FDA labeling, clinical trials, peer-reviewed literature). Presents new or updated criteria at clinical meetings, communicates updates internally and externally as needed, and supports clinical inquiries. Ensures compliance with all operational policies and guidelines.

Responsibilities:

• Collaborate with clinical teams to develop and maintain evidence-based clinical criteria.
• Participate in clinical committees (e.g., DPD, TAC, P&T, VAC).
• Create customized client criteria and coordinate dissemination.
• Work with Account Management, Implementation, and Strategy teams on new client implementations and expansions.
• Respond to client inquiries, review policies, provide education, support clinical meetings, and assist with audits.
• Support clinical algorithm development, program development, and quality improvement efforts.
• Coordinate with Clinical Operations IT, Quality, and Compliance teams as needed.
• Perform other duties as assigned.

Education & Experience:

• Doctor of Pharmacy (PharmD) or Bachelor of Science in Pharmacy.
• At least 1 year of pharmacy, managed care, or pharmaceutical industry experience.
• Current pharmacist license in good standing in the state of employment.

Must be eligible to work in the U.S. without sponsorship.

Additional Qualifications:

• Strong interpersonal, organizational, and communication skills.
• Ability to review and interpret data.
• Team-oriented mindset.

Preferred Qualifications:

• Managed care experience (Health Plan or PBM).
• Oncology experience.
• Board certification or specialty certification.
• P&T committee participation.

Physical Demands:

• Up to 20% travel.
• Reaching, standing, walking, stooping, lifting up to 25 pounds.
• Visual acuity requirements.

Potential salary ranges from $108,000 to $184,000 based on experience. Benefits details are available on our website.

Prime Therapeutics is an equal opportunity employer and values diversity. We welcome applicants from all backgrounds, including those requiring reasonable accommodations.