Licensed Pharmacist Clinical Review

To support a remote healthcare initiative, the full-time Pharmacist Clinical Review will evaluate prior authorization requests, apply clinical knowledge for coverage determinations, and collaborate with healthcare providers while maintaining compliance with established protocols. Key responsibilities Evaluate and review prior authorization requests based on clinical criteria and plan design Communicate case decisions to healthcare providers, patients, and health plans efficiently Collaborate with the Prior Authorization team and handle inbound and outbound calls to resolve escalations Required qualifications Bachelor's degree in pharmacy (BS Pharmacy) Active pharmacist license in the state of residence 1-3 years of prior work experience as a pharmacist 2 years of experience in prior authorization Ability to interpret clinical guideline criteria and apply clinical knowledge appropriately