Remote Clinical Pharmacist — UM & Formulary

WellSense Health Plan; United States; Remote; USD 89,000 - 129,000; Full time

Benefits offered by this job

Full-time remote work

Competitive salaries

Job summary

WellSense Health Plan is seeking a Clinical Pharmacist I to lead pharmacy utilization management and support PBM coordination and formulary advisory activities. The role includes reviewing prior authorization, ensuring compliance with benefits and quality of care, and contributing to MTM and case reviews. Strong pharmacology knowledge and Massachusetts licensure are required. This is a remote, full-time opportunity with competitive pay.

Qualifications

• Licensed Massachusetts pharmacist
• 1–2 years clinical experience preferred
• Pharmac Therapeutics Committee experience preferred

Responsibilities

• Ensure PBM and UM processes align with coverage and quality measures
• Review and authorize pharmacy prior authorization requests
• Ensure adherence to regulatory standards for pharmacy programs
• Research new drugs and provide formulary recommendations
• Collaborate with PBM to identify cost savings and quality improvements
• Prepare data for Pharmacy and Therapeutics Committee presentations
• Engage in care management activities as needed
• Perform medication reconciliation outreach to members in care management

Skills

Pharmacology expertise

MS Office

Education

Bachelor of Pharmacy

Doctor of Pharmacy preferred

Tools

Microsoft Office

Job description

WellSense Health Plan is seeking a Clinical Pharmacist I to lead pharmacy utilization management and support PBM coordination and formulary advisory activities. The role includes reviewing prior authorization, ensuring compliance with benefits and quality of care, and contributing to MTM and case reviews. Strong pharmacology knowledge and Massachusetts licensure are required. This is a remote, full-time opportunity with competitive pay.