Licensed Coverage Review Pharmacist

A company is looking for a Coverage Review Pharmacist to evaluate prior authorization requests and ensure safe medication use.

Key Responsibilities

Evaluate and render clinical decisions for medication prior authorization requests

Ensure compliance with regulatory and internal quality standards

Collaborate with teams to enhance workflow quality and decision support tools

Required Qualifications

Doctor of Pharmacy (PharmD) degree from an accredited institution

Active, unrestricted U.S. pharmacist license in good standing

2 years of experience in prior authorization or clinical pharmacy review

Strong understanding of PBM operations and benefit design workflows

Proficiency with prior authorization platforms and PBM claims systems