Temporary Pharmacist (Part-time)

SCAN Health Insurance•Long Beach, CA

4d•$50•Remote

About The Position

Founded in 1977 as the Senior Care Action Network, SCAN began with a simple but radical idea: that older adults deserve to stay healthy and independent. That belief was championed by a group of community activists we still honor today as the “12 Angry Seniors.” Their mission continues to guide everything we do. Today, SCAN is a nonprofit health organization serving more than 500,000 people across Arizona, California, Nevada, New Mexico, Texas, and Washington, with over $8 billion in annual revenue. With nearly five decades of experience, we have built a distinctive, values-driven platform dedicated to improving care for older adults. Our work spans Medicare Advantage, fully integrated care models, primary care, care for the most medically and socially complex populations, and next-generation care delivery models. Across all of this, we are united by a shared commitment: combining compassion with discipline, innovation with stewardship, and growth with integrity. At SCAN, we believe scale should strengthen—not dilute—our mission. We are building the future of care for older adults, grounded in purpose, accountability, and respect for the people and communities we serve. This position will play an instrumental role in ensuring compliance and clinical appropriateness of Part D coverage determinations, appeals and grievances, and Part C organizational determinations for a senior-focused Medicare Advantage Plan. The Clinical Pharmacist will work alongside the Director to execute and ensure CMS compliant operations and strong star rating performance for these areas. In addition, the Clinical Pharmacist will support Interdisciplinary Care Team work, and complete medication-related clinical reviews to support the care management teams at SCAN. The Clinical Pharmacist will participate in other managed care responsibilities as assigned.

Requirements

Pharm. D. degree.
Current Pharmacist Licensure in California required.
Ability to work cross-functionally across the organization.
Excellent written/oral communication skills.
Self-starter who can work independently.
Ability to multi-task in a fast environment.
Ability to research, analyze, and problem solve.
Strong critical thinking skills.

Nice To Haves

Completion of residency/fellowship in Managed Care preferred.

Responsibilities

PBM (ESI) oversight of Part D coverage determinations, including review of clinical appropriateness, regulatory compliance, documentation quality, and timeliness issues
Internal IRR reviews of Part D appeals to ensure decisions are clinically sound, compliant with CMS requirements, and well‑documented prior to external escalation
MEIR Quality of Care (QOC) tasks, including review, documentation, and follow‑up on potential access or processing issues
Coverage criteria maintenance and updates, including remediation from the mock Part D audit finding to correct non‑formulary criteria containing questions unrelated to indication or formulary alternatives
Management of escalated and complex member issues requiring clinical review, cross‑team coordination, and timely resolution
Support for ad hoc and time‑sensitive requests such as audit support, case look‑backs, issue investigations, and leadership inquiries
Exhibit professionalism and empathy in all interactions with members and provider partners.
Utilize department desktop procedures, workflows, job aids and training material.
Adhere to all quality, compliance, and regulatory standards.
Actively support the achievement of SCAN’s Vision and Goals.
Other duties as assigned.

Benefits

Medical Benefits
Paid Sick Time
Excellent 401(k) Retirement Saving Plan
Robust employee recognition program
An opportunity to become part of a team that makes a difference to our members and our community every day!
A competitive compensation and benefits program
An annual employee bonus program
Generous paid-time-off (PTO)
Eleven paid holidays per year
Excellent Retirement Savings program
A work-life balance
An opportunity to become part of a team that makes a difference to our members and our community every day!