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Clinical Pharmacist
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Clinical Pharmacist

Job Snapshot

Base Pay $55.00 - $58.00 /Hour
Other Pay Depends on experience
Employment Type Per Diem
Job Type Pharmaceutical, Health Care, Other
Education Not Specified
Experience At least 1 year(s)
Manages Others Yes
Relocation No
Industry Employment - Recruiting - Staffing, Other Great Industries
Required Travel Negligible

Job Description


Position Responsibilities:


  • Review specialty medication prior authorization requests (i.e. biopharmaceuticals) according to established treatment protocols, clinical criteria and member benefits. and make coverage determinations within the defined turnaround times and meet regulatory requirements
  • Responsible for clinical criteria for specialty medications including analysis, monitoring of industry trends and develop criteria recommendations for Pharmacy and Therapeutics Committee and clients
  • Define and coordinate prior authorization and drug utilization reviews reports for clients and ensure regulatory reporting requirements for drug utilization review and fraud and abuse reporting are met
  • Oversee the drug utilization review and medication therapy management programs for specialty medications at the assigned plan to meet regulatory requirements and develop systematic reviews of prescription claims to meet strategic initiatives
  • Develop and design specialty medication clinical edits for claims adjudication and enhanced drug utilization review
  • Provide clinical guidance, support and oversight to the assigned Pharmacy Technicians
  • Develop and review guideline criteria for prior authorization and non-formulary drugs in support of Pharmacy and Therapeutics Committee function and pharmacy benefit design.
  • Ensure and evaluate quality controls and implement opportunities for performance improvement in pharmacy practice specific to specialty pharmacy
  • Research drug information to maintain drug knowledge and disease state understanding for application to prior authorization reviews.

Job Requirements



Bachelor’s degree or advanced degree (PharmD., M.S) in pharmacy.  5+ years of mail order, retail or hospital pharmacy, including 1+ years of specialty medication pharmacy experience or experience in the Clinical Pharmacist role in a similar pharmacy setting. 


Licenses/Certifications:  Current state’s Pharmacist license



Knowledge Worker:  Critical Thinking/Execution, Adaptability/Flexibility, Communication/Relationship Development, Technical and Professional Knowledge

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Clinical Pharmacist

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