Remote Clinical Pharmacist | Work from Home

Job Overview

Join a passionate team dedicated to enhancing healthcare outcomes for Medicaid members in the role of Clinical Pharmacist. This remote position, based in Hawaii, offers you the opportunity to work from home while playing an essential role in managing drug therapy for a Medicaid health plan. As a Clinical Pharmacist, you will be responsible for making critical decisions regarding drug utilization, handling prior authorization requests, and supporting health plan initiatives to ensure optimal care for our members.

Key Responsibilities

• Review and evaluate prior authorization requests, making well-informed decisions on drug products based on member benefits and coverage criteria.
• Develop and enforce criteria for medication analysis, ensuring compliance with regulatory standards for drug utilization reviews and fraud prevention.
• Formulate and recommend clinical criteria for non-formulary and non-preferred medications, offering expert guidance to clients.
• Oversee drug utilization review and medication therapy management programs, ensuring adherence to Medicare Part D and contributing to strategic initiatives.
• Create and implement clinical edits to enhance drug utilization at the point of sale, utilizing evidence-based practices.
• Provide support and clinical oversight to pharmacy technicians, promoting high-quality performance and continuous professional development.
• Review and establish guidelines for prior authorization and non-formulary drugs to support Pharmacy and Therapeutics Committees and pharmacy benefit design.
• Assess pharmacy practices and identify opportunities for performance improvement to maintain quality control and achieve optimal member outcomes.
• Stay current on drug information and disease state knowledge to uphold clinical expertise for prior authorization evaluations.
• Perform additional responsibilities as assigned and adhere to company policies and standards.
  
  

Qualifications

• A Bachelor's degree or advanced degree (PharmD, M.S.) in pharmacy.
• A minimum of 3 years of experience in retail or hospital pharmacy, or at least 1 year in managed care pharmacy.
• Clinical pharmacy experience in managed healthcare is preferred.
• Active, unrestricted Pharmacist license in Hawaii (additional state licenses may be necessary based on geographical or contractual requirements).
  
  

Career Growth Opportunities

This role provides avenues for professional development and continuous learning, enhancing your skills and enabling growth within the field of clinical pharmacy.

Company Culture And Values

We pride ourselves on fostering a culture of collaboration and support, with an emphasis on high-quality work and continuous improvement. The remote work setting allows flexibility while providing a crucial opportunity to impact healthcare positively.

Compensation And Benefits

The annual salary range for this role is between \(103,500 - \)191,600, contingent upon experience and qualifications. If you are seeking a chance to leverage your pharmacy expertise while making a significant difference in healthcare, we are eager to connect with you!

Employment Type: Full-Time