Policy Clinical Pharmacist- REMOTE

Prime Therapeutics; Carson City (NV); Remote; USD 108,000 - 184,000; Full time

Job summary

A leading healthcare solutions provider is seeking a Policy Clinical Pharmacist for a remote position. This role involves creating and updating medical necessity criteria, supporting client inquiries, and collaborating with clinical teams. Candidates should hold a PharmD and possess relevant pharmacy experience. Competitive salary range between $108,000 and $184,000 based on experience. Join a diverse team committed to impactful healthcare solutions.

Qualifications

• 1+ years of pharmacy, managed care, or pharmaceutical industry experience.
• Current pharmacist license in good standing.
• Must be eligible to work in the U.S. without sponsorship.

Responsibilities

• Create and update medical necessity criteria via clinical evidence evaluation.
• Support client inquiries and maintain clinical criteria.
• Collaborate with clinical committees and assist in program development.

Skills

Interpersonal skills

Consultation skills

Organizational skills

Data review and interpretation skills

Written communication skills

Verbal communication skills

Education

Doctor of Pharmacy (PharmD) or Bachelor of Science Pharmacy Degree

Job description

Overview

Our work matters. We help people get the medicine they need to feel better and live well. We do not lose sight of that. It fuels our passion and drives every decision we make.

Job Title

Policy Clinical Pharmacist - REMOTE

Job Description

Creates new and updates existing specialty medical necessity criteria through evaluation of available clinical evidence (e.g., FDA labeling, pivotal clinical trials, authoritative compendia, peer‑reviewed literature). Present new/updated criteria at clinical meetings, relay updates internally to relevant partners, as well as externally as determined by business need. Provides support for clinical client inquiries. Complies with all standard operating procedures, policies, guidelines, and work instructions.

Responsibilities

• Collaborates with clinical personnel in the development and maintenance of evidence-based clinical criteria.
• Participates in and supports the clinical committees (e.g. DPD, TAC, P&T, VAC) as applicable.
• Creates customized Client criteria and coordinates the dissemination of such.
• Collaborates with Account Management as well as the Implementation and Strategy teams regarding new Client implementations as well as expansions to existing business; including clinical projects as determined by business needs.
• Client support, including but not limited to, responding to inquiries, customization of policies, Client policy review, education, QBR support, clinical meetings, audit assistance, special projects, etc.
• Supports clinical algorithm development and maintenance as determined by business needs.
• Supports program development (e.g., Enhanced Oncology Value, Regimens) and improvement efforts based upon business needs.
• Collaborates with Clinical Operations IT, Quality, and Compliance as needed for program support.
• Other duties as assigned

Education & Experience

• Doctor of Pharmacy (PharmD) or Bachelor of Science Pharmacy Degree
• 1 years of pharmacy, managed care and/or pharmaceutical industry experience
• Current pharmacist license in good standing with the State Board of Pharmacy in the State where the position is located.

Must be eligible to work in the United States without the need for work visa or residency sponsorship.

Additional Qualifications

• Strong interpersonal, consultation, organizational, tracking and follow-up skills.
• Excellent verbal and written communication skills.
• Ability to collaborate and work well as a team.
• Data review and interpretation skills required.

Preferred Qualifications

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

Physical Demands

• Ability to travel up to 20% of the time
• Frequently required to reach with hands and arms
• Occasionally required to stand, walk and stoop, kneel, and crouch
• Occasionally required to lift and/or move up to 10 pounds and occasionally lift and/or move up to 25 pounds.
• Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus

Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their job, and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.

Potential pay for this position ranges from $108,000.00 - $184,000.00 based on experience and skills.

To review our Benefits, Incentives and Additional Compensation, visit our Benefits Page and click on the "Benefits at a glance" button for more detail.

Prime Therapeutics LLC is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sex (pregnancy, sexual orientation, and gender identity), national origin, disability, age, veteran status, or any other legally protected class under federal, state, or local law.

We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law.

Prime Therapeutics LLC is a Tobacco-Free Workplace employer.

Positions will be posted for a minimum of five consecutive workdays.

Prime Therapeutics' fast-paced and dynamic work environment is ideal for proactively addressing the constant changes in today's health care industry. Our employees are involved, empowered, and rewarded for their achievements. We value new ideas and work collaboratively to provide the highest quality of care and service to our members.

If you are looking to advance your career within a growing, team-oriented, award-winning company, apply to Prime Therapeutics today and start making a difference in people's lives.

Prime Therapeutics LLC is a Tobacco-Free Workplace employer.

If you are an applicant with a disability and need a reasonable accommodation for any part of the employment process, please contact Human Resources at 1.866.469.1257 or email [e-mail].