Pharmacist, Advisor

Gainwell Technologies LLC•Any city, OH

4d•$90,900 - $129,900•Remote

About The Position

As a Prior Authorization Pharmacist, review clinical documentation and Preferred Drug List criteria to determine the appropriateness of medication therapy and prior authorization requests. Collaborate with internal and external stakeholders to evaluate and continuously improve utilization management strategies, clinical programs, and pharmacy operations. This is a remote position, with work hours in the Eastern Time Zone.

Requirements

Doctor of Pharmacy (PharmD) or Bachelor of Science in Pharmacy with relevant specialty experience.
Active, unrestricted pharmacist license in the applicable state.
At least four years of clinical pharmacy experience, including clinical reviews using recognized drug compendia, clinical guidelines, and clinical trial data.
Strong analytical, research, communication, and problem-solving skills, with the ability to translate clinical findings into practical recommendations.
Strong collaboration and team skills.
Proficiency in Microsoft Office and ability to quickly learn proprietary systems.

Responsibilities

Conduct clinical evaluations of medication therapy and review prior authorization requests using established clinical guidelines and Preferred Drug List criteria.
Participate in peer-to-peer discussions with medical providers regarding prior authorization reviews, clinical determinations, and appropriate medication therapy.
Provide clinical pharmacy consultations and interventions, including reviewing prior authorization data to identify prescribing trends and opportunities for intervention.
Support Clinical Call Center and Prior Authorization operations by providing pharmacy expertise and assisting with communications to members, providers, and internal teams.
Collaborate with Medical Directors, Clinical Pharmacists, Clinical Specialty Pharmacists, and other stakeholders to maintain clinical integrity and advance pharmacy program best practices.
Identify and support quality and operational improvements that enhance the efficiency and effectiveness of pharmacy programs and services.