Remote Pharmacist: Clinical Utilization & PA

Navitus Health Solutions / Lumicera Health Services; United States; Remote; USD 100,000 - 170,000; Full time

Benefits offered by this job

Health, Dental, and Vision insurance

20 days paid time off

4 weeks paid parental leave

401K company match up to 5%

Adoption Assistance Program

Flexible Spending Account

Educational Assistance Plan

Professional Membership assistance

Referral Bonus up to $750

Job summary

Archimedes is seeking a Pharmacist, Clinical Utilization Management to join our team remotely. You will serve as the clinical expert for specialty medications across both pharmacy and medical benefits, communicating with physicians, nurses, pharmacists, and members on high-cost cases, dose management, and cost controls.

The role includes peer-to-peer consultations, external clinical outreach, prior authorization, and policy development.

Qualifications

• Clinical communication with physicians, nurses, pharmacists.
• Experience with prior authorization processes and utilization management.
• Ability to analyze clinical data and cost implications.

Responsibilities

• Develop and deliver clinical messages to physicians, members, clients, and consultants.
• Manage prior authorization, high-cost cases, claims editing and policy development.
• Perform outreach to prescribers to obtain information and support timely case resolution.
• Communicate with prescribers and stakeholders via phone, email, or fax.

Skills

Clinical communication

Team collaboration

Prior authorization

Education

Pharmacist degree / PharmD

Unrestricted pharmacist license

Board Certification preferred

Tools

Microsoft Excel

PowerPoint

Word

Job description

Archimedes is seeking a Pharmacist, Clinical Utilization Management to join our team remotely. You will serve as the clinical expert for specialty medications across both pharmacy and medical benefits, communicating with physicians, nurses, pharmacists, and members on high-cost cases, dose management, and cost controls.

The role includes peer-to-peer consultations, external clinical outreach, prior authorization, and policy development.