Clinical Administrative Pharmacist - Remote TN

Prime Therapeutics • Home, WV

3d • $108,000 - $184,000 • Remote

About The Position

The Clinical Administrative Pharmacist delivers clinical and regulatory analysis that supports operations and the implementation of clinical and regulated programs, including benefit-plan coverage lists, formulary management, and publications. The role participates in internal and client-initiated projects by conducting analysis and ensuring compliance with quality assurance standards. It provides direct support for benefit-plan functions and contributes to regulatory requirements and pharmacy-related initiatives.

Requirements

• Doctor of Pharmacy (PharmD) or Bachelor of Science Pharmacy degree.
• At least 1 year of work experience in clinical, retail, hospital, or managed care.
• Current pharmacist license to practice in the applicable state(s).
• Must be eligible to work in the United States without requiring work visa or residency sponsorship.
• Knowledge of AS400, queries, and Lotus Notes.
• Strong analytical and problem-solving skills, with attention to detail and quality.
• Ability to manage multiple projects simultaneously under pressure and strict timelines.
• Skill in developing and improving process efficiencies.
• Strong collaboration skills and ability to work in a team-oriented environment.
• Proficiency with Microsoft Excel and Word.
• Must understand, comply with, and attest to job-specific security responsibilities and controls, and comply with applicable legal, regulatory, contractual, and internal requirements.
• Must be able to perform the essential job functions; reasonable accommodations may be made for employees with disabilities, absent undue hardship.

Nice To Haves

• MediSpan or First Databank experience.
• Formulary Database/Workplace management tool experience.
• Claim adjudication system experience.
• Board of Pharmacy Specialties (BPS) certification, pharmacy residency, or fellowship.

Responsibilities

• Partner with internal stakeholders and clients to develop and maintain project and benefit-plan testing scenarios, including utilization management and specialty offerings.
• Interpret project requests to determine feasibility, document requirements, and provide technical solutions.
• Conduct testing, including creating test plans, executing tests, and performing User Acceptance Testing for quality assurance.
• Identify and resolve system issues, perform root-cause analysis, and escalate problems to avoid service disruption.
• Ensure benefit plans comply with federal, CMS, state, local, and pharmacy regulatory requirements.
• Develop, maintain, and verify data for drug utilization and claims adjudication systems to support evidence-based benefit coverage decisions.
• Support concurrent Drug Utilization Review service messages, table settings, testing, and adjudication workflows to ensure accuracy and compliance with established protocols and implementation decisions.
• Collaborate with leaders to implement client-requested formulary changes and provide subject-matter expertise to internal and external committees.
• Perform other duties as assigned.

What This Job Offers

• Job Type: Full-time