Pharmacist – Clinical Pharmacist Advisor Medicare
Job Description
NOW HIRING: Clinical Pharmacist Advisor – Medicare
I’m currently recruiting for a Clinical Pharmacist Advisor – Medicare opportunity with a leading healthcare organization.
This is a great opportunity for a licensed pharmacist looking to apply their clinical knowledge to Medicare Part D appeals and pharmacy benefit requests while working in a fast-paced, quality-focused environment.
Key Responsibilities
• Review and accurately set up Medicare Part D cases
• Evaluate clinical information to support appropriate case decisions
• Review internal notes and fax requests for relevant clinical information
• Conduct provider outreach when additional information is needed
• Apply clinical judgment, drug compendia, Medicare guidance, and work instructions
• Ensure decisions comply with CMS/Medicare requirements and mandated timelines
• Complete accurate and timely documentation
• Meet departmental productivity and quality standards
• Participate in development discussions and incorporate supervisor feedback
• Support a high-quality experience for Medicare members and providers
Ideal Candidate
Bachelor’s degree in Pharmacy or PharmD required
Active pharmacist license in good standing in state of residence
Strong clinical judgment and attention to detail
Ability to interpret clinical information and make accurate decisions
Excellent written and verbal communication skills
Strong documentation and organizational skills
Familiarity with Medicare Part D and/or managed care/PBM environments preferred
Previous Managed Care/PBM experience preferred, but not required
High School Diploma/GED: Required and must be verifiable
Training Schedule: Monday–Friday
Training Hours: 9:00 AM–5:30 PM EST