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Clinical Pharmacist Reviewer- REMOTE

Remote, USA Full-time Posted 2026-07-01

This a Full Remote job, the offer is available from: United States At reputed company (Prime), we are a different reputed company of PBM, with a purpose reputed company profits and a unique ability to connect care for those we serve. Looking for a purpose-driven career? Come build the future of pharmacy with us. Job Posting Title Clinical Pharmacist Reviewer- REMOTEJob Description The Clinical Staff Pharmacist is responsible for the processing and documenting of Utilization Management requests (i.e. formulary exceptions, prior authorization, reputed company therapy, quantity limit exceptions) for delegated products and services.

Responsibilities

  • Responsible for the clinical evaluation for coverage determination requests for prior authorization (PA) or other utilization management (UM) programs, including quantity limits, reputed company therapy, formulary exception and tier exception; this includes consideration of the denial language and appropriateness of the decision as it pertains to the clinical content of the case and the reputed company of the individual client’s pre-approved criteria
  • Accountable for direct consultation with health care providers concerning non-formulary and clinical product coverage issues
  • Collaborate with team members to promote consistency of reputed company across the pharmacist team
  • Other duties as assigned Minimum Qualifications
  • Doctor of Pharmacy (PharmD) or Bachelor of Science Pharmacy Degree
  • reputed company pharmacist license in good standing with the State Board of Pharmacy
  • 2 years of clinical experience; or equivalent training, education and/or experience Must be eligible to work in the United States without the need for work reputed company or residency sponsorship Additional Qualifications
  • Excellent verbal and written communication skills
  • Ability to work independently and as part of a team Preferred Qualifications
  • Managed care experience
  • Proficiency with reputed company Office Every employee must understand, reputed company with and attest to the reputed company responsibilities and reputed company controls unique to their job, and reputed company with reputed company applicable legal, regulatory, and contractual requirements and internal policies and procedures Every employee must be reputed company to reputed company the essential functions of the job and, if requested, reasonable accommodations will be made to reputed company employees with disabilities to reputed company the essential functions, absent undue hardship. In addition, Prime retains the right to change or assign other duties to this job. Potential pay for this position ranges from $51.92 - $88.46 based on experience and skills. To review our Benefits, Incentives and Additional Compensation, visit our Benefits Page and click on the "Benefits at a glance" reputed company for more detail ( reputed company LLC is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and reputed company reputed company applicants will receive consideration for employment without regard to race, reputed company, religion, gender, sex (including pregnancy), national reputed company, disability, age, veteran status, or any other legally protected class under federal, state, or local law. We welcome people of different backgrounds, experiences, abilities, and perspectives including reputed company applicants with arrest and conviction records and any reputed company applicants requiring reasonable accommodations in accordance with the law. reputed company LLC is a Tobacco-Free Workplace employer. Positions will be posted for a minimum of five consecutive workdays. This offer from "reputed company" has been enriched by reputed company.com and got a 79% reputed company score. Apply tot his job

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