Sr. Clinical Pharmacist- REMOTE

At Prime Therapeutics (Prime), we are a different kind of PBM, with a purpose beyond profits and a unique ability to connect care for those we serve. Looking for a purpose-driven career? Come build the future of pharmacy with us.

Job Posting Title

Sr. Clinical Pharmacist- REMOTE

Job Description

The Clinical Pharmacist is responsible for the clinical and regulatory analysis activities required for the implementation of clinical and regulated programs, including coverage lists in support of client benefits. This position is responsible for participating in internal, client-initiated and regulatory projects. This position is also responsible for supporting quality assurance needs and analytical activities related to benefit plans.

Responsibilities

• Partner with Quality Audit team and/or other roles to develop and maintain project and benefit plan testing scenarios including utilization management, specialty and new client offerings
• Interpret project requests to determine feasibility, develop business requirements and assist with developing technical solutions
• Document process for execution and conduct User Acceptance Testing (UAT) for quality assurance
• Identify system problems, resolve set-up issues and/or escalate system defects with a sense of urgency to avoid member disruption
• Ensure benefit plans are in compliance with all regulations including federal, CMS, state, local and pharmacy
• Develop, maintain and verify drug lists with claims adjudication systems to support benefit coverage decisions and contingent therapy, quantity limits, and prior authorization programs
• Develop and maintain point of service messages and concurrent Drug Utilization Review table settings, and ensure accuracy of claims adjudication through weekly MediSpan product file maintenance and quarterly P&T implementation decisions
• Other duties as assigned

Minimum Qualifications

• Doctor of Pharmacy (PharmD) or Bachelor of Science Pharmacy Degree

• Current pharmacist license in good standing with the State Board of Pharmacy in the State where the position is located
• 1 year of work experience in clinical, retail, hospital, or managed care
• Must be eligible to work in the United States without need for work visa or residency sponsorship

Must be eligible to work in the United States without the need for work visa or residency sponsorship

Additional Qualifications

• Strong analytical and problem-solving skills with attention to detail and quality
• Ability to work on multiple projects simultaneously under pressure with strict timelines
• Ability to develop process efficiencies
• Ability to work well in team environment
• Microsoft Excel and Word proficiency

Preferred Qualifications

• MediSpan or First Databank experience
• Formulary Database management experience
• Knowledge of AS400, queries, and Lotus Notes
• RxClaim experience

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 $124,000.00 - $211,000.00 based on experience and skills.

To review our Benefits, Incentives and Additional Compensation, visit our Benefits Page and click on the "Benefits at a glance" button for more detail (https://www.primetherapeutics.com/benefits).

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 (including pregnancy), 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.

Positions will be posted for a minimum of five consecutive workdays.