Clinical Pharmacist

Job Description

We are seeking an experienced and clinically driven Managed Care Pharmacist to join a remote healthcare team supporting medication therapy management, clinical pharmacy services, and population health initiatives. This role is ideal for candidates with strong managed care experience, expertise in prior authorizations and drug utilization review, and the ability to collaborate with interdisciplinary healthcare teams to deliver evidence-based, cost-effective patient care.

Job Title: Clinical Pharmacist Specialist (Managed Care)

Location: Remote

Shift: Days

Pay: $55-60/hourly

Schedule: Monday – Friday | 5x8s

Hours: 8:00 AM – 5:00 PM

Contract Duration: 26 Weeks

Start Date: 06/15/2026

Role Overview:

The Clinical Pharmacist Specialist (CPS) will provide comprehensive clinical pharmacy services including medication therapy management (MTM), prior authorization review, drug utilization management, specialty pharmacy coordination, and clinical policy development. The pharmacist will collaborate closely with physicians, nurses, case managers, and healthcare teams to optimize medication therapy outcomes, improve patient safety, and support cost-effective care delivery.

Key Responsibilities:

• Perform medication therapy management (MTM) and clinical pharmacy consultations
• Review and evaluate pharmacy and medical claims for appropriateness and compliance
• Conduct prior authorizations, appeals, audits, and clinical case reviews
• Develop medication-related action plans and therapeutic recommendations
• Identify and resolve medication-related problems including drug interactions, dosing concerns, and adherence barriers
• Collaborate with physicians, nurses, pharmacists, and care teams to optimize patient outcomes
• Participate in drug utilization review (DUR), policy development, and Pharmacy & Therapeutics Committee activities
• Provide patient, provider, and staff education regarding medication therapies and disease management
• Analyze pharmacy data and support population health management initiatives
• Maintain accurate clinical documentation and ensure compliance with healthcare regulations and quality standards
• Participate in quality improvement initiatives, research activities, and professional education programs

Requirements:

• PharmD required
• Active Pharmacist License in Oregon, Washington, or California required
• Minimum 3 years of managed care pharmacist experience required
• Experience with prior authorizations, appeals, audits, and ALJ hearings required
• PGY-1 Residency required with relevant clinical experience
• Strong knowledge of clinical pharmacology, evidence-based medicine, and medication therapy management
• Experience with pharmacy claims processing platforms and healthcare data analysis required
• EPIC experience preferred
• Excellent communication, presentation, analytical, and organizational skills
• Ability to work independently in a fast-paced remote environment

About Pride Health-Pride Health offers eligible employee’s comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance and hospital indemnity), 401(k)-retirement savings, life & disability insurance, an employee assistance program, legal support, auto, home insurance, pet insurance, and employee discounts with preferred vendors

Equal Employment Opportunity

Pride Health is an equal opportunity employer. We do not discriminate on the basis of the race, religious creed, color, national origin, ancestry, physical disability, mental disability, reproductive health decision making, medical condition, genetic information, marital status, sex, gender, gender identity, gender expression, age, sexual orientation, veteran or military status, or any other characteristic protected by applicable federal, state, or local law.

Fair Chance Employment

Pride Health is a Fair Chance employer. We consider all qualified applicants, including those with criminal histories, in a manner consistent with applicable state and local Fair Chance laws and ordinances, including the California Fair Chance Act and all applicable local Fair Chance ordinances.

Accommodations

We are committed to providing reasonable accommodations to applicants and employees with disabilities. If you require a reasonable accommodation to participate in the application or interview process, or to perform the essential functions of this role, please contact us.