Clinical Pharmacist — Appeals & Formulary Strategy
Job in
Springfield, Hampden County, Massachusetts, 01101, USA
Listed on 2026-08-15
Listing for:
Fallon Health
Full Time
position Listed on 2026-08-15
Job specializations:
-
Healthcare
Job Description & How to Apply Below
Fallon Health seeks a clinical pharmacist to review and render clinical decisions for provider and member appeals and grievances on medications across all lines of business. You will collaborate with Appeals & Grievance teams, Medical Directors, and prior authorization vendors, ensuring timely reviews and adherence to plan criteria.
Role requires MA licensure, 3 years in pharmacy with managed care exposure, and strong data analysis using EMRs and MS Office tools.
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