[Remote] Clinical Pharmacist Advisor- Remote
Note: The job is a remote job and is open to candidates in USA. Gainwell Technologies is a leader in healthcare solutions, and they are seeking a Clinical Pharmacist Advisor. The role involves conducting clinical evaluations and collaborating with various stakeholders to manage the Medicaid prescription drug program effectively.
Responsibilities
- Conduct clinical evaluations of medication therapy and review prior authorization requests using PDL criteria
- Facilitate peer-to-peer discussions with providers regarding prior authorization decisions
- Collaborate with prescribers and internal teams on clinical consultations and targeted interventions
- Support call center operations by providing clinical guidance and assisting with provider/member communications
- Serve as a subject matter expert for pharmacy-related questions across the organization
- Contribute to quality improvement initiatives and program enhancements
- Maintain clinical expertise and collaborate with cross-functional teams on pharmacy best practices
- Provide input on drug utilization reviews and formulary management
- Support Medicaid Drug Rebate Program operations and assist with state pharmacy audits
- Deliver training to pharmacy providers and contribute to reporting and administrative activities
Skills
- Registered Pharmacist with respective State Licensure
- At least 5 years of experience working in a pharmacy setting or pharmacy benefit management system
- Knowledge of Medicaid at the state and/or federal level
- Knowledge of pharmacy-related aspects of Medicaid
- Working knowledge of HIPAA regulations and requirements
- PharmD (preferred) or Bachelor of Pharmacy degree
Benefits
- Generous, flexible vacation policy
- A 401(k) employer match
- Comprehensive health benefits
- Educational assistance
- A variety of leadership and technical development academies to help build your skills and capabilities
Company Overview
Company H1B Sponsorship