Remote Clinical Pharmacist: Programs & Prior Authorization

Spectraforce Technologies

Raleigh (NC)

On-site

USD 55,104 - 82,656

Part time

14 days+

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Benefits offered by this job

Remote work

Job summary

Spectraforce Technologies is seeking a Clinical Pharmacist 1 for a remote 6-month assignment. The role supports Medicaid, Medicare and Health Exchange lines, with a schedule of 10 am - 6:30 pm EST and potential overtime.

You will define formularies, review prior authorization requests, and assist internal teams while ensuring quality controls and program development for DUR in Medicaid and Medicare. Candidates must hold PharmD/Bachelor of Pharmacy, be licensed, and have 1–3 years of pharmacy

Qualifications

Bachelor's degree or PharmD; 2+ years mail order/retail/hospital/ managed care pharmacy experience or 1+ years residency.
Current state pharmacist license with no restrictions.
Flexibility to work a weekend rotation.

Responsibilities

Develop criteria for medications; recommend plan design changes and clinical programs.
Monitor prior authorization requests.
Provide clinical support to internal departments and address clinical questions.
Ensure quality controls and identify opportunities for improvement in pharmacy practice.
Develop programs impacting DUR for Medicaid and Medicare.
Develop, implement, and maintain pharmacy policies and procedures.
Coordinate Medicare MTM program.
Assist case management with clinical rounds presentations.