Clinical Staff Pharmacist- REMOTE - Rhode Island Staffing : Job Details

Our work matters. We help people get the medicine they need to feel better and live well. It fuels our passion and drives every decision we make.

The Clinical Staff Pharmacist is responsible for the processing and documenting of Utilization Management requests (i.e. formulary exceptions, prior authorization, step therapy, quantity limit exceptions) for delegated products and services.

• Responsible for the clinical evaluation for coverage determination requests for prior authorization (PA) or other utilization management (UM) programs, including quantity limits, step therapy, formulary exception and tier exception; this includes consideration of the denial language and appropriateness of the decision as it pertains to the clinical content of the case and the intent of the individual client's pre-approved criteria.
• Accountable for direct consultation with health care providers concerning non-formulary and clinical product coverage issues.
• Collaborate with team members to promote consistency of decisions across the pharmacist team.
• Other duties as assigned.

• Doctor of Pharmacy (PharmD) or Bachelor of Science Pharmacy Degree
• Current pharmacist license in good standing with the State Board of Pharmacy
• 2 years of clinical experience; or equivalent training, education and/or experience
• Must be eligible to work in the United States without the need for work visa or residency sponsorship

• Excellent verbal and written communication skills
• Ability to work independently and as part of a team

• Managed care experience
• Proficiency with Microsoft Office

Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their job, and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures. Every employee must be able to perform the essential functions of the job and, if requested, reasonable accommodations will be made to enable employees with disabilities to perform the essential functions, absent undue hardship. In addition, Prime retains the right to change or assign other duties to this job.

Potential pay for this position ranges from $51.92 - $88.46 based on experience and skills.

Prime Therapeutics LLC is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sex (pregnancy, sexual orientation, and gender identity), national origin, disability, age, veteran status, or any other legally protected class under federal, state, or local law. We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law. Prime Therapeutics LLC is a Tobacco-Free Workplace employer.

If you are an applicant with a disability and need a reasonable accommodation for any part of the employment process, please contact Human Resources at 1.866.###.#### or email [email protected].