Remote Clinical Pharmacist - Formulary & Regulatory Specialist

Prime Therapeutics; Minneapolis (MN); Remote; USD 108,000 - 184,000; Full time

Job summary

Prime Therapeutics is seeking a Clinical Administrative Pharmacist to work remotely supporting clinical and regulatory analysis for benefit plans, formulary management, and publications. The role involves testing, data verification, and collaboration with internal and client teams to ensure compliance and effective coverage decisions.

The position requires a PharmD or BS in Pharmacy, a current pharmacist license, and at least 1 year of relevant work experience, with a wide range of

Qualifications

• Doctor of Pharmacy (PharmD) or Bachelor of Science Pharmacy Degree.
• 1 year of work experience in clinical, retail, hospital, or managed care.
• Current Pharmacist license in applicable state(s).
• Eligible to work in the United States without visa or residency sponsorship.

Responsibilities

• Develop and maintain project and benefit plan testing scenarios including utilization management.
• Interpret requests to determine feasibility and provide technical solutions.
• Conduct testing with test plans, execution, and UAT for QA.
• Identify and resolve system issues; perform root-cause analysis.
• Ensure beneficiary plans comply with regulatory requirements (federal, CMS, state, local).
• Develop and verify data for drug utilization and claims adjudication to support coverage decisions.
• Support DRR messages, table settings, testing and adjudication workflows.
• Collaborate with leaders to implement formulary changes and provide SME input to committees.

Skills

Analytical thinking

Problem-solving

Multi-project management

Team collaboration

Education

PharmD or BS Pharmacy

Tools

AS400

Lotus Notes

Microsoft Excel

Microsoft Word

MediSpan/First Databank

Claim adjudication systems

Job description

Prime Therapeutics is seeking a Clinical Administrative Pharmacist to work remotely supporting clinical and regulatory analysis for benefit plans, formulary management, and publications. The role involves testing, data verification, and collaboration with internal and client teams to ensure compliance and effective coverage decisions.

The position requires a PharmD or BS in Pharmacy, a current pharmacist license, and at least 1 year of relevant work experience, with a wide range of