Remote Clinical Pharmacist Utilization Management

ZP Group; North Carolina; Remote; USD 114,000 - 128,000; Part time

Benefits offered by this job

Medical coverage

Dental coverage

Vision coverage

401K

Job summary

Piper Companies currently seeks a Clinical Pharmacist for a fully remote contract role. You will support utilization management, coverage determinations, and clinical pharmacy operations within a fast-paced managed care environment.

Ideal candidates hold a PharmD or equivalent and an active license, with 3+ years in managed care and strong skills in analysis, documentation, and collaboration with pharmacy technicians.

Qualifications

• Active, unrestricted pharmacist license in at least one U.S. state.
• Minimum of 3 years of experience in managed care, prior authorization review, utilization management, or a related clinical pharmacy setting.
• Familiarity with pharmacy coding and classification systems.
• Strong analytical, clinical decision-making, communication, and documentation abilities.

Responsibilities

• Conduct clinical evaluations of prior authorization and exception requests using established benefit design requirements and evidence-based coverage criteria.
• Analyze utilization management activity and prepare reports that support compliance monitoring and organizational oversight initiatives.
• Maintain accurate documentation and tracking of review cases to ensure regulatory adherence and operational consistency.
• Provide day-to-day clinical support and subject matter expertise to pharmacy technicians involved in authorization workflows.
• Review drug literature, formulary guidance, and therapeutic recommendations to support benefit management programs and quality improvement efforts.

Skills

Utilization management

Clinical decision-making

Documentation

Communication skills

Education

Bachelor's degree in Pharmacy

PharmD

Tools

NDC coding

GCN

GPI

NCPDP

USC

Job description

Piper Companies currently seeks a Clinical Pharmacist for a fully remote contract role. You will support utilization management, coverage determinations, and clinical pharmacy operations within a fast-paced managed care environment.

Ideal candidates hold a PharmD or equivalent and an active license, with 3+ years in managed care and strong skills in analysis, documentation, and collaboration with pharmacy technicians.