Clinical Pharmacist I

PharmacistPharmacistFull TimeRemoteJuniorTeam 501-1,000Since 2013H1B No SponsorCompany SiteLinkedIn

Location

United States

Posted

2 days ago

Salary

$113.3K - $170.0K / year

Seniority

Junior

Bachelor Degree1 yr expEnglish

Job Description

Clinical Pharmacist I

Alignment Health

• Review and render Part D coverage determination and appeal requests. • Conduct comprehensive medication reviews via telephone for members enrolled in the MTM program. • Participate in pharmacy quality improvement projects aligned with Medicare Star Ratings. • Maintain appropriate records of all clinical reviews, coverage determinations, and consultations in accordance with CMS timelines.

Job Requirements

  • Minimum of 1 year of experience working at a health plan, Pharmacy Benefit Manager (PBM), or in a managed care pharmacy setting.
  • Bachelor's degree in Pharmacy or a related health science field.
  • Active and unrestricted Pharmacist license in the applicable state(s).
  • In-depth understanding of CMS Medicare Part D coverage determination and appeal processes.
  • Proficiency in conducting CMR and TMR reviews; familiarity with MTM platforms and documentation requirements.

Benefits

  • Health insurance
  • Flexible work arrangements
  • Professional development

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