Working from home in Pennsylvania, the full-time salaried Pennsylvania Licensed Pharmacist will manage pharmacy benefits, perform medical necessity reviews, and develop clinical criteria while ensuring high-quality member care and satisfaction. Key responsibilities Act as a liaison between the Health Plan and customers regarding pharmaceutical benefits Perform extensive literature reviews and develop clinical criteria for new and existing pharmaceuticals Support internal operations with information on pharmacy and medical drug benefits, formulary details, and prior authorizations Required qualifications Bachelor's Degree in Pharmacy (preferred) Active and unrestricted Pennsylvania Pharmacist license within 90 days Experience in pharmacy benefit management and clinical operations Knowledge of formulary management and prior authorization processes Ability to perform medical necessity reviews according to specified timelines