Clinical Pharmacist

Position Title : Clinical Pharmacist I

Location : Remote (Florida only)

Duration : 3-Month Contract | Possible Extension

Schedule : Monday–Friday, 9 : 00 AM–6 : 00 PM EST (No OT)

About the Role

This position supports prior authorization (PA) reviews for prescription medications across various health plans. The Clinical Pharmacist evaluates clinical information, applies policy criteria, and communicates directly with providers to ensure appropriate, evidence-based decisions. The workflow is steady and deadline-driven, with a high volume of daily cases and close collaboration with pharmacy technicians and clinical team members.

Key Responsibilities

• Review completed prior authorization requests and technician-recommended denials for clinical appropriateness.
• Validate member information, eligibility, coverage details, and prior decisions.
• Assess prescription claim history, chart notes, and lab results.
• Apply medical policy criteria and determine whether requests meet approval standards.
• Use clinical judgment for cases without established P&T criteria; draft and support new criteria where needed.
• Research drug information and provide clinical guidance to providers and pharmacy technicians.
• Communicate with physicians regarding non-formulary drugs, benefit exclusions, quantity limits, age restrictions, and alternatives.
• Retrieve, analyze, and compile data for utilization reporting, audits, criteria updates, and P&T support.
• Contribute to formulary management through recommendations and analysis.

Requirements

Education : PharmD required

License : Active Florida Pharmacist license required

Experience : Minimum 1 year of professional pharmacist (RPh) experience

Nice to Have :

Performance Expectations :