Remote Clinical Pharmacist: Utilization & Prior Auth

Select Source International

Durham (NC)

Remote

USD 110,000 - 140,000

Full time

3 days ago

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Job summary

Select Source International is seeking a Clinical Pharmacist for a 12-month remote NC assignment. You will work 40 hours per week, M-F 8–5 EST, supporting prior authorization reviews and clinical guidance for pharmacy technicians.

Requirements include a state license, a bachelor's or advanced degree, and 3–5 years in retail/HMO/DSP. You will analyze benefit criteria, ensure quality controls, and stay current with drug coding (NDC/GCN/GPI) and NCPDP adjudication systems.

Qualifications

Bachelor's degree or advanced degree and current state pharmacy license.
3–5 years of experience in related field (retail, HMO, DSP).
Pharmacist license and relevant industry experience required.

Responsibilities

Review prior authorization requests and determine coverage criteria.
Report utilization review statistics to corporate compliance committees.
Summarize daily utilization review numbers and track case compliance.
Provide clinical guidance to pharmacy technicians.
Knowledge of drug coding (NDC, GCN, GPI, USC) and NCPDP adjudication systems.
Review guideline criteria for prior authorization and non-formulary drugs.
Ensure quality controls and identify opportunities for improvement in pharmacy practices.
Research drug information to support prior authorization reviews.