Review appeals for commercial and Part D, render determinations based on clinical guidelines, plan criteria, and regulatory requirements.
Serve as a clinical reviewer and provide subject matter support to the Appeals Clinical team.
Perform independent research of medical literature and guidelines to render appeal determinations.

Qualifications:

PharmD and 3+ years experience or equivalent combination.
Current unrestricted license as a Registered Pharmacist in any US state.
Computer skills: Microsoft Office Suite and relational databases.

Work Environment:

On-site at San Diego HQ or remote with management approval.
Exempt level requiring flexibility to work beyond traditional hours.
Typical core business hours Monday to Friday 8am to 5pm.

MedImpact Healthcare Systems Inc.

MedImpact delivers leading edge pharmaceutical and technology related solutions that improve the value of healthcare, providing transparency and choice. Privately-held for over three decades, it is one of the leading pharmacy benefit managers in America, committed to making prescription benefits understandable and accessible.

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