Clinical Care Pharmacist - Medicare Remote

The Clinical Care Pharmacist plays a vital role in promoting safe, effective, and appropriate medication use. This position is responsible for reviewing prior authorization requests, supporting clinical programs, and providing expert guidance to members, providers, and pharmacies. The role combines clinical decision-making with a strong focus on service excellence in a fast-paced, collaborative environment. Responsibilities include reviewing prior authorization requests, appeals, and override requests using clinical guidelines, ensuring compliance with regulations across various plans, documenting clinical decisions, and providing empathetic support to members and prescribers. The position requires staying current with clinical guidelines and reporting potential fraud.