Clinical Pharmacist - 173866

Responsibilities: for the Clinical Pharmacist include: · Evaluate prior authorization and coverage review requests by applying clinical guidelines, plan benefits, and formulary requirements to determine medication eligibility. · Monitor utilization management activities, analyze pharmacy review metrics, and prepare reports supporting compliance and operational objectives. · Serve as a clinical resource for pharmacy technicians by providing guidance on pharmacy benefit policies, drug therapies, and review processes. · Conduct research on medications, treatment protocols, and disease state management to support coverage decisions and formulary initiatives. · Identify opportunities for quality improvement within pharmacy operations and assist with implementing process enhancements to improve accuracy and efficiency. Qualifications: for the Clinical Pharmacist include: · Active North Carolina Pharmacist license and current residence within North Carolina. · Minimum of 3 years of pharmacist experience with a background in retail pharmacy and Medicare Part D programs. · Previous telephonic experience working for a Health Insurance Company, Managed Care Organization, or Pharmacy Benefit Management environment. · Strong knowledge of pharmacy claims adjudication, NCPDP systems, and drug coding classifications including NDC, GCN, GPI, and related standards. · Bachelor's degree in Pharmacy, PharmD, or advanced healthcare-related degree with demonstrated stability and long-term success in contract-based roles. Compensation: for the Clinical Pharmacist: · Hourly Rate: $50-$60 · Comprehensive Benefits: Medical, Dental, Vision, 401(k), Sick Leave (as required by law), and Paid Holidays This job opens for applications on 9/25/26. Applications for this job will be accepted for at least 30 days from the posting date.