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Clinical Pharmacist
Remote / Online - Candidates ideally in
Durham, Durham County, North Carolina, 27703, USA
Listed on 2026-10-15
Durham, Durham County, North Carolina, 27703, USA
Listing for:
Greenkey Resources LLC
Remote/Work from Home
position Listed on 2026-10-15
Job specializations:
-
Healthcare
Clinical Pharmacist, Healthcare Compliance
Job Description & How to Apply Below
- The Clinical Pharmacist will review prior authorization requests and determine drug coverage based on member benefits and criteria.
- Provide clinical guidance and support to pharmacy technicians, ensuring adherence to compliance and quality standards.
- Analyze utilization review statistics and report findings to corporate compliance committees for informed decision-making.
- Evaluate and implement opportunities for performance improvement in pharmacy practices and benefit designs.
- Maintain up-to-date drug knowledge and disease state understanding for effective prior authorization reviews.
- Collaborate with Pharmacy and Therapeutics Committees to review guideline criteria for non-formulary drugs.
- Ensure quality control measures are in place and track compliance of review cases effectively.
- Work remotely, offering flexibility while contributing to impactful pharmacy operations and member care.
Key Responsibilities & Duties
- Review prior authorization requests for drug products and ensure compliance with member benefits and coverage criteria.
- Analyze daily utilization review data and summarize findings for reporting purposes.
- Track compliance of review cases and implement quality control measures.
- Provide clinical guidance and mentorship to assigned pharmacy technicians.
- Research drug information to maintain expertise in drug coding and claims adjudication systems.
- Collaborate with committees to review guideline criteria for prior authorization and non-formulary drugs.
- Evaluate and implement opportunities for performance improvement in pharmacy practices.
- Ensure compliance with corporate standards and contribute to strategic pharmacy benefit designs.
Job Requirements
- Doctor of Pharmacy (PharmD) degree is required for this position.
- Minimum of 3 years of experience in a related field, with 5 years preferred.
- Active pharmacy license in the applicable state is mandatory.
- Proficiency in drug coding systems (NDC, GCN, GPI, USC) and claims adjudication systems.
- Strong analytical skills to summarize utilization review data and track compliance.
- Ability to provide clinical guidance and mentorship to pharmacy technicians.
- Knowledge of pharmacy benefit design and prior authorization criteria.
- Experience in remote work environments and ability to collaborate effectively with teams.
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