Supporting Medicare Part D members and providers, the full-time Licensed Medicare Part D Pharmacist will manage pharmacy benefit requests and clinical reviews while working remotely with flexible hours. Key responsibilities Support Medicare Part D members and providers with pharmacy benefit and coverage determination requests Ensure accurate case setup and complete clinical review of Medicare appeals in compliance with CMS guidelines Accurately document all Medicare Part D requests and maintain compliance with CMS-mandated timelines Required qualifications Licensed Pharmacist Knowledge of Medicare Part D regulations, including coverage determinations and appeals (CMS guidelines) Experience with PBMS, Utilization Management, or Prior Authorization review highly preferred