Clinical - Clinical Pharmacist 1 - 210392 Job at Pacer Group, North Carolina

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  • Pacer Group
  • North Carolina

Job Description

Job Description:

Job Title: Clinical Pharmacist 1

Assignment Duration: 6 Months (Possible Extension & Conversion)

Location: Remote
Working Hours: Monday Friday, 9:00 AM 5:30 PM

Position Overview

The Clinical Pharmacist I support Pharmacy Services by reviewing and adjudicating prior authorization requests for medical benefit (buy-and-bill) medications across Medicare, Medicaid, Exchange, and Commercial lines of business. This fully remote role requires strong clinical judgment, in-depth drug knowledge, and experience in managed care or pharmacy benefit management environments.

Key Responsibilities

  • Review and adjudicate prior authorization requests for medical benefit (buy-and-bill) drugs using established clinical criteria

  • Apply evidence-based guidelines to approve or deny provider medication requests

  • Develop and maintain clinical criteria, policies, and procedures related to pharmacy operations

  • Support utilization management, drug utilization review (DUR), and quality improvement initiatives

  • Collaborate with internal clinical teams, case management, and pharmacy leadership

  • Provide clinical consultation and respond to medication-related inquiries from internal stakeholders

  • Participate in Medicare Medication Therapy Management (MTM) programs

  • Assist case management teams through clinical rounds and complex case reviews

  • Meet productivity and quality benchmarks ( 40 cases/day; 90% production, 95 99% quality targets)

  • Maintain accurate documentation and compliance with regulatory and organizational standards

Required Qualifications

Education

  • Bachelor's degree in Pharmacy or Doctor of Pharmacy (PharmD)

Licensure

  • Active, unrestricted Pharmacist license (State-ranked preference below)

Experience

  • 1+ years of experience in retail, hospital, managed care, PBM, or mail-order pharmacy

  • Prior experience reviewing prior authorizations strongly preferred

Preferred Qualifications

  • Managed care or PBM prior authorization review experience

  • Medical benefit (buy-and-bill) drug review experience

  • Strong clinical decision-making skills

  • Experience with Outlook, Microsoft Teams, SharePoint, and Excel

  • Ability to work independently in a high-volume, metrics-driven environment

Preferred State Licenses (Ranked)

  1. North Carolina

  2. California

  3. New Jersey

  4. Arizona

  5. Kansas

  6. Texas

  7. Indiana

  8. Georgia

Why This Role

  • Fully remote opportunity

  • High-impact role supporting multiple lines of business

  • Temp-to-perm conversion potential

  • Strong alignment with culture of accountability, curiosity, trust, and service

Job Tags

Permanent employment, Temporary work, Monday to Friday,

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