Remote Clinical Pharmacist: Utilization & Coverage Expert

ZP Group

United States

Remote

USD 69,000 - 83,000

Full time

9 days ago

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Benefits offered by this job

Medical benefits

Dental benefits

Vision benefits

401(k)

Sick leave

Paid holidays

Job summary

Piper Companies is seeking a Clinical Pharmacist to join a remote contract opportunity based in North Carolina. The Clinical Pharmacist will support pharmacy utilization management activities, evaluate medication coverage requests, and provide clinical expertise to ensure appropriate benefit determinations for members while maintaining compliance with regulatory and organizational standards.

Located nationwide, this contract role requires NC licensure with experience in retail/pharmacy benefits

Qualifications

Active North Carolina Pharmacist license and residence in NC.
3+ years pharmacist experience in retail and Medicare Part D.
Telephonic experience in health plan or PBM environments.
Knowledge of pharmacy claims adjudication, NCPDP, NDC/GCN/GPI standards.
PharmD or higher with demonstrated stability in contract roles.

Responsibilities

Evaluate prior authorization and coverage requests using guidelines and formulary.
Monitor utilization management activities and prepare compliance reports.
Serve as clinical resource for technicians on benefit policies and processes.
Conduct research to support formulary initiatives and coverage decisions.
Identify opportunities for process improvements in pharmacy operations.