Pharmacist - Medicare

Remote Clinical Pharmacist

We are seeking a dedicated Clinical Pharmacist to join our team in a fully remote capacity. You will be responsible for reviewing utilization management requests and making informed decisions based on client-specific criteria. This role requires precision, clinical judgment, and effective communication with healthcare providers and team members.

Responsibilities

• Review and evaluate commercial members' utilization management requests, including formulary exceptions, prior authorization, step therapy, and quantity limit exceptions.
• Utilize client-specific criteria to determine approval or denial of prior authorizations.
• Conduct clinical evaluations for coverage determination requests, considering denial language and decision appropriateness.
• Consult directly with healthcare providers or members on non-formulary and clinical product coverage issues.
• Collaborate with team members to ensure consistency in decision-making across the pharmacist team.
• Participate in routine structured touchpoints and communicate regularly with supervisors and team members via Teams, phone, and video calls.

Essential Skills

• Doctor of Pharmacy (PharmD) or Bachelor of Science in Pharmacy degree.
• Current pharmacist license in good standing with the State Board of Pharmacy where the position is located.
• Minimum of two years of experience in retail, managed care, or clinical pharmacy.
• Ability to prioritize tasks and manage multiple projects simultaneously.
• Proficiency in making independent clinical decisions and adapting to change.

Additional Skills & Qualifications

• Comfortable with learning new computer systems and proficient in basic IT troubleshooting.
• Skilled in using multiple monitors and Microsoft Word and Excel.
• Ability to type 45+ words per minute.
• Familiarity with pharmacy benefits management is not preferred but beneficial

Job Type & Location: This is a Contract to Hire position based out of Eagan, MN.

Pay and Benefits: The pay range for this position is $55.00 - $55.00/hr. Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: Medical, dental & vision; Critical Illness, Accident, and Hospital; 401(k) Retirement Plan Pre-tax and Roth post-tax contributions available; Life Insurance (Voluntary Life & AD&D for the employee and dependents); Short and long-term disability; Health Spending Account (HSA); Transportation benefits; Employee Assistance Program; Time Off/Leave (PTO, Vacation or Sick Leave)

Workplace Type: This is a fully remote position.

Application Deadline: This position is anticipated to close on Jun 11, 2026.