Remote MTM Pharmacist

Remote Mtm Pharmacist

This MTM Pharmacist role focuses on defining and developing standard and custom formularies while providing comprehensive medication therapy management support for health plan members. You will use your clinical expertise to design and implement pharmacy programs, evaluate drug utilization, and support internal teams with evidence-based recommendations. The position offers the opportunity to influence plan design, improve quality of care for Medicaid and Medicare populations, and ensure safe, effective, and cost-conscious medication use.

Responsibilities

• Define and develop standard and custom formularies for assigned plans to support safe, effective, and cost-efficient medication use.
• Develop clinical criteria for medications and recommend plan design changes that align with best practices and regulatory requirements.
• Design, implement, and support clinical programs that enhance medication therapy management and overall pharmacy performance.
• Monitor and review prior authorization requests to ensure appropriate medication use and adherence to formulary and clinical criteria.
• Provide clinical support to internal departments by answering clinical questions and offering evidence-based recommendations.
• Ensure appropriate quality controls within pharmacy operations and identify opportunities for performance improvement in pharmacy practice.
• Develop, implement, and maintain policies and procedures for the pharmacy department to support consistent, compliant, and efficient workflows.
• Develop and implement programs designed to impact Drug Utilization Review (DUR) for both Medicaid and Medicare populations.
• Participate in the coordination and ongoing management of the Medicare Medication Therapy Management (MTM) program.
• Assist the case management team by reviewing member cases, participating in clinical rounds, and presenting clinical findings and recommendations.
• Review patients' medical information and pharmacy claims to identify gaps in care, drug therapy problems, and opportunities for therapy optimization.
• Maintain a high level of productivity, meeting an expectation of approximately 90% daily productivity while sustaining clinical quality.
• Perform accurate and timely data entry and documentation related to pharmacy claims, prior authorizations, and MTM activities.
• Use computer systems and pharmacy software to support clinical decision-making, documentation, and reporting.

Essential Skills

• Bachelor's degree in Pharmacy or an advanced degree such as Pharm.D. or M.S. in Pharmacy.
• 2+ years of experience in mail order, retail, hospital, or managed care pharmacy, or at least 1+ year of pharmacy residency program experience.
• Current, active Pharmacist license in good standing with no restrictions.
• Pharmacist licensure in the state of residence.
• Strong knowledge of medication therapy management (MTM) principles and practices.
• Experience working with Medicaid and Medicare pharmacy benefits and regulations.
• Proficiency in reviewing medical information and pharmacy claims to identify gaps in care and drug therapy problems.
• Ability to meet and maintain a high productivity standard, including an expectation of approximately 90% daily productivity.
• Solid computer skills and comfort working with pharmacy and clinical information systems.

Additional Skills & Qualifications

• Experience in managed care pharmacy, including formulary management and benefit design support.
• Familiarity with Drug Utilization Review (DUR) programs and related clinical interventions.
• Comfort providing clinical support to multidisciplinary internal teams, including case management.
• Strong attention to detail in data entry and documentation.
• Effective communication skills for presenting clinical rounds and explaining clinical recommendations.
• Ability to develop and maintain pharmacy policies and procedures.
• Capability to identify and implement performance improvement opportunities in pharmacy practice.
• Experience supporting or coordinating Medicare MTM programs.

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

Pay and Benefits: The pay range for this position is $60.00 - $70.00/hr. Individual compensation offered for this position within this range will depend on many factors, including qualifications, skills, relevant experience, job knowledge, geographic location, internal equity, and other pertinent job-related factors. 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 Sep 2, 2026.