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Clinical Pharmacist 1

Spectraforce Technologies
United States, North Carolina, Raleigh
500 West Peace Street (Show on map)
Jun 24, 2025
Position Title: Clinical Pharmacist 1 Work Location: Remote Assignment Duration: 6 months Work Schedule: 10 am - 6:30 pm EST, OT possible Position Summary: Define and develop standard and custom formularies for assigned plan. Background & Context: This team reviews medication prior authorization requests and coverage determinations for the Medicaid, Medicare and Health Exchange lines of business. Key Responsibilities: Develop clinical criteria for medications, recommend plan design changes, and clinical programs to be initiated Monitor prior authorization requests Provide clinical support to internal departments and address clinical related questions Ensure appropriate quality controls and initiates opportunities for performance improvement in pharmacy/practice Develop and implement programs designed to impact DUR for both Medicaid and Medicare Develop, implement, and maintain policies and procedures for the pharmacy department Participate in the coordination of the Medicare MTM program Assist case management team with members including clinical rounds presentations Qualification & Experience: Bachelor's degree or advanced degree (Pharm.D., M.S.) in pharmacy 2+ years of mail order, retail, hospital or managed care pharmacy experience OR 1+ years of pharmacy residency program experience Current state's Pharmacist license with no restrictions Notes: A typical day consists of reviewing 140 to 160 clinical prior authorizations or coverage determinations Candidate Requirements Education/Certification: Required: Bachelors / PharmD Licensure: Required: Current state's pharmacist license