Pharmacist - Clinical Pharmacist Advisor Medicare

Our Client, a Retail Pharmacy company, is looking for a Pharmacist - Clinical Pharmacist Advisor Medicare for their Remote location.

Responsibilities:

• The role involves ensuring the accuracy of case setup and clinical review of Medicare appeals cases by thoroughly reviewing internal notes or fax requests for pertinent information, providing clear and concise documentation, and contacting providers when necessary to obtain clinical details for case decisions.
• It requires adherence to work instructions and Medicare guidelines to ensure proper case processing.
• The position also demands compliance with CMS-mandated timelines, as well as departmental productivity and quality standards.
• Clinical judgment and knowledge must be applied effectively, utilizing drug compendia resources, evolving work instructions, and CMS Medicare guidance.
• Additionally, the role includes participating in development discussions and receiving feedback from the direct supervisor to support continuous improvement.

Requirements:

• Previous experience in Managed Care/PBM environment (preferred).
• Bachelor's degree in pharmacy or Pharm D. required.
• Must have an active license in good standing in state of residence.

Why Should You Apply?

• Health Benefits
• Referral Program
• Excellent growth and advancement opportunities