Make an impact in healthcare from the comfort of your home. We're seeking a detail-oriented Clinical Pharmacist who is passionate about improving patient outcomes, ensuring appropriate medication utilization, and supporting quality pharmacy care through prior authorization reviews and clinical decision-making.
Location: Remote (North Carolina Resident Required) Pay Rate: $70/hour Employment Type: Contingent Schedule: Day Shift, Monday-Friday
As a Clinical Pharmacist, you will play a critical role in ensuring members receive safe, effective, and clinically appropriate medication therapy. Your expertise will help support coverage decisions, maintain compliance standards, and contribute to high-quality pharmacy benefit management.
• Review prior authorization requests and make coverage determinations based on member benefits and established clinical criteria • Analyze utilization review data and summarize daily review statistics • Track review case compliance and support regulatory requirements • Provide clinical guidance and support to pharmacy technicians • Evaluate guideline criteria for prior authorization and non-formulary medication requests • Support Pharmacy and Therapeutics Committee initiatives and pharmacy benefit design efforts • Ensure quality control standards are maintained and identify performance improvement opportunities • Research drug information and disease states to support accurate clinical decision-making • Utilize knowledge of drug coding systems (NDC, GCN, GPI, and USC) and NCPDP claims adjudication processes
• A current, up-to-date resume • Bachelor's Degree in Pharmacy or advanced pharmacy degree required • PharmD preferred • Current Pharmacist license in the state of North Carolina • Minimum of 3 years of pharmacist experience in a related setting • Experience working in a remote/work-from-home environment • Strong computer proficiency and ability to navigate multiple systems efficiently • Ability to manage a high-volume workload and prioritize effectively • Experience in retail pharmacy, health plan, HMO, DSNP, or managed care environments preferred • Medicare and Medicaid experience preferred • Medication Therapy Management (MTM) and Comprehensive Medication Review (CMR) experience preferred • Knowledge of pharmacy benefit management and utilization review processes • Ability to meet compliance requirements • Must be eligible and provide proof of eligibility to work in the US
• Competitive pay • Fully remote work opportunity • Consistent Monday-Friday daytime schedule • Opportunity to work with a leading healthcare organization • Gain experience in prior authorization, utilization management, and managed care pharmacy • Collaborative team environment with opportunities to expand clinical expertise
Benefits for Manpower Associates (Upon Eligibility)
Upon completion of waiting period associates are eligible for:
• Medical and Prescription Drug Plans • Dental Plan • Supplemental Life Insurance • Short Term Disability Insurance • 401(k)
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