Remote LTC Clinical Pharmacist – ATI & Claims

Clarest Health OHIO, LLC; Dayton (OH); Hybrid; USD 110,000 - 115,000; Full time

Benefits offered by this job

Medical, Dental & Vision Insurance

Paid Time Off

Telemedicine

401k with company match

Referral Bonuses

Life Insurance

Job summary

Clarest Health OHIO, LLC is seeking a Clinical Service Center Pharmacist to oversee clinical claim reject activity and approve appropriate formulary alternatives. You will review prior authorization documentation and guide CSC staff to resolve rejected claims, ensuring compliance with state and federal regulations.

Training occurs onsite for 8 weeks, with ongoing hybrid work after training. The role requires a PharmD and Ohio licensure eligibility, with strong attention to detail and excellent

Qualifications

• PharmD required and eligible for licensure in Ohio.
• License must be in good standing.
• Experience in LTC pharmacy is preferred.

Responsibilities

• Oversee clinical claim reject activity.
• Recommend clinically comparable formulary alternatives.
• Review and approve clinical documentation for prior authorization.
• Instruct CSC Technicians on actions for rejected claims resolution.
• Collaborate with LTC departments to meet daily volume and service goals.
• Maintain organized CSC documentation for ATI or claims management.

Skills

Attention to detail

Clinical knowledge

Problem solving

Time management

Effective communication

Education

Doctor of Pharmacy (PharmD)

Ohio licensure eligibility

Job description

Clarest Health OHIO, LLC is seeking a Clinical Service Center Pharmacist to oversee clinical claim reject activity and approve appropriate formulary alternatives. You will review prior authorization documentation and guide CSC staff to resolve rejected claims, ensuring compliance with state and federal regulations.

Training occurs onsite for 8 weeks, with ongoing hybrid work after training. The role requires a PharmD and Ohio licensure eligibility, with strong attention to detail and excellent