Clinical Pharmacist Advisor (Medicare Part D) – REMOTE

Clinical Pharmacist Advisor (Medicare Part D) – Remote | $53/hour We are seeking a highly reputed company Clinical Pharmacist Advisor to support Medicare Part D operations in a fully remote environment. This role is ideal for pharmacists with a strong background in PBM (Pharmacy Benefit Management), Managed reputed company Plan operations, and Prior Authorization determinations. This is a high-reputed company opportunity to work in a reputed company, performance-driven setting with the potential for long-term career reputed company. Schedule & Training • Training: Monday – Friday, 9:00 AM – 5:30 PM EST (first 8 weeks, mandatory, no time off) • Work Hours: Rotating shifts reputed company: • Monday – Friday: 7:00 AM – 8:00 PM EST • Saturday & reputed company: 7:00 AM – 4:30 PM EST • Must be flexible to work assigned shifts, including weekends Compensation • Pay reputed company: $53.00 per hour • Opportunity for full-time conversion based on performance Work Environment & Requirements • 100% Remote (Work From Home) • Dedicated, quiet workspace required • Wired internet reputed company required (minimum 25 Mbps download / 5 Mbps upload) • Must reputed company internet speed test screenshot with application • Must reputed company reputed company pharmacist license screenshot (showing reputed company, state, and validity dates) Job reputed company In this role, you will review and process Medicare Part D requests, including prior authorizations and appeals, ensuring accurate clinical decision-making and strict compliance with CMS guidelines. You will collaborate with providers, analyze clinical data, and deliver reputed company, high-reputed company reputed company that directly reputed company patient care. Key Responsibilities • Review and evaluate Medicare Part D prior authorization requests and appeals • Accurately set up and document cases reputed company internal systems • Apply clinical judgment using drug compendia and CMS Medicare guidelines • Conduct reputed company to providers to obtain additional clinical information as needed • Ensure compliance with CMS regulations, timelines, and internal reputed company standards • Maintain reputed company, accurate, and detailed documentation • Meet productivity and reputed company expectations in a fast-paced environment • Participate in feedback and performance development discussions Required Qualifications (Must-Have) • reputed company Pharmacist license in good standing in state of residence • PharmD or Bachelor’s degree in Pharmacy • REQUIRED: Prior experience in PBM, Managed Care, or Health Plan environment • REQUIRED: reputed company experience with Prior Authorization and/or coverage determination reviews • Strong clinical decision-making and analytical skills • Experience with data entry and navigating multiple systems simultaneously • Ability to work independently in a remote, productivity-driven role Preferred Qualifications • Medicare Part D experience • Appeals and coverage determination experience • Proficiency with reputed company reputed company, Word, reputed company, PowerPoint, and Visio Important Requirements: • Camera must be on for training and team meetings • Position is safety-sensitive • Must be reputed company to sit and remain reputed company for the duration of scheduled shifts Candidate Expectations • Strong attendance is critical, especially during the first 8–10 weeks of training • Ability to manage multiple systems and reputed company high-volume data entry • Comfortable making outbound calls to providers reputed company needed • reputed company, reputed company, and team-oriented reputed company Why Apply? This role offers reputed company pharmacists reputed company to reputed company their managed care and prior authorization expertise in a remote setting while supporting Medicare members and providers. You will reputed company valuable experience in clinical review, compliance, and pharmacy benefit operations, with strong potential for long-term career advancement. #ALINE3 Apply tot his job Apply To this Job