Clinical Pharmacist
$70 per hourManpower Group Inc.
Looking for a clinical role where your expertise directly impacts patient care and pharmacy operations? This opportunity allows you to leverage your clinical judgment and analytics skills to support prior authorization decisions and optimize pharmacy benefit outcomes in a collaborative, high-impact environment.
Location : Remote (NC residency required)Pay Rate : $70/hour
Schedule : M-F, 8:30am-5pm
Employment Type: Contingent
Start Date: Immediate Why This Role Matters
In this role, you'll play a critical part in ensuring patients receive appropriate, evidence-based medication therapy while maintaining compliance with benefit design and regulatory standards. Your work supports quality, safety, and cost-effective care delivery. What You'll Do
- Review prior authorization requests and make coverage determinations in accordance with member benefits and clinical criteria
- Analyze and report utilization review statistics to corporate compliance committees
- Monitor and summarize daily utilization review data and trends
- Track compliance of review cases and ensure adherence to established guidelines
- Provide clinical guidance and oversight to pharmacy technicians
- Apply knowledge of drug coding (NDC, GCN, GPI, USC) and NCPDP claims adjudication systems
- Evaluate guideline criteria for prior authorization and non-formulary drugs to support Pharmacy & Therapeutics Committee functions
- Identify quality control gaps and implement performance improvement initiatives
- Conduct drug information research to support clinical decision-making and maintain disease state expertise
- A current, up-to-date resume
- Bachelor's degree or advanced degree in Pharmacy or related field
- 3-5+ years of experience in a clinical pharmacy or utilization review setting
- Active, current state pharmacist license
- Strong knowledge of pharmacy benefit management and prior authorization processes
- Experience with claims adjudication systems and drug coding standards
- Ability to interpret clinical guidelines and apply them to case reviews
- Medicare and Medicaid experience a plus
- Excellent analytical, communication, and documentation skills
- Ability to meet compliance requirements
- Opportunity to work in a highly impactful clinical decision-making role
- Exposure to pharmacy benefit strategy and utilization analytics
- Collaborative, team-oriented work environment
- Professional growth in managed care and clinical pharmacy operations
- Opportunity to influence quality and performance improvements
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)
Vacancy posted 4 days ago
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