NEW JOB OPENING
CLINICAL PHARMACIST ADVISOR MEDICARE
IN Remote, USA!

Required Education:

• Bachelor’s degree in Pharmacy or PharmD



Required License/Certification:

• Active Pharmacist license in good standing in the state of residence



Required Qualifications/Skills/Experience:

• Data entry experience

• Strong computer literacy, including Microsoft Excel and Word

• Ability to navigate multiple computer applications using two screens

• Ability to work independently in a productivity-driven environment

• Ability to sit and focus without interruptions for the duration of the shift

• Ability to maintain a dedicated, quiet, separate workspace for remote work

• Strong attention to detail and accuracy

• Ability to meet productivity and quality standards



Preferred Qualifications/Skills/Experience:

• Previous experience in a Managed Care/PBM environment

• Knowledge of Microsoft Access, PowerPoint, and Visio

• Previous experience with Medicare Part D

• Experience reviewing clinical information and applying Medicare guidelines



Clinical Pharmacist Advisor Medicare Overview:

• The Clinical Pharmacist Advisor Medicare supports Medicare Part D members and providers with requests related to pharmacy benefits

• The role is responsible for accurately setting up cases, reviewing clinical information for decision-making, and conducting outreach to providers when additional information is needed

• The position requires timely and accurate documentation while ensuring compliance with Medicare guidelines, CMS requirements, drug compendia, work instructions, and departmental quality and productivity standards

• The pharmacist will use clinical judgment and pharmacy knowledge to support appropriate case processing and decisions

• This is a fully remote, work-from-home position requiring a dedicated, quiet workspace and reliable wired internet

• Candidates must be licensed pharmacists in good standing in their state of residence and comfortable working independently in a highly structured, data-entry and productivity-focused environment

• The position also includes virtual interviews and requires candidates to remain on camera during training, supervisor meetings, and team meetings



Job Duties:

• Ensure accurate setup and processing of Medicare appeals cases

• Review internal notes and fax requests for pertinent clinical information

• Review clinical information to support appropriate case decisions

• Contact providers to obtain additional clinical information when necessary

• Apply Medicare guidelines, CMS requirements, drug compendia, and applicable work instructions

• Complete accurate and timely documentation of Medicare Part D requests

• Ensure compliance with required regulatory timelines

• Meet departmental productivity and quality standards

• Participate in development discussions and incorporate supervisor feedback

• Support continuous improvement initiatives





#CV1

• **Only those lawfully authorized to work in the designated country associated with the position will be considered.**

• **Please note that all Position start dates and duration are estimates and may be reduced or lengthened based upon a client’s business needs and requirements.**