Note: The job is a remote job and is open to candidates in USA. Gainwell Technologies is a leader in healthcare solutions, and they are seeking a Clinical Pharmacist Advisor. The role involves conducting clinical evaluations and collaborating with various stakeholders to manage the Medicaid prescription drug program effectively.

Responsibilities

• Conduct clinical evaluations of medication therapy and review prior authorization requests using PDL criteria
• Facilitate peer-to-peer discussions with providers regarding prior authorization decisions
• Collaborate with prescribers and internal teams on clinical consultations and targeted interventions
• Support call center operations by providing clinical guidance and assisting with provider/member communications
• Serve as a subject matter expert for pharmacy-related questions across the organization
• Contribute to quality improvement initiatives and program enhancements
• Maintain clinical expertise and collaborate with cross-functional teams on pharmacy best practices
• Provide input on drug utilization reviews and formulary management
• Support Medicaid Drug Rebate Program operations and assist with state pharmacy audits
• Deliver training to pharmacy providers and contribute to reporting and administrative activities

Skills

• Registered Pharmacist with respective State Licensure
• At least 5 years of experience working in a pharmacy setting or pharmacy benefit management system
• Knowledge of Medicaid at the state and/or federal level
• Knowledge of pharmacy-related aspects of Medicaid
• Working knowledge of HIPAA regulations and requirements
• PharmD (preferred) or Bachelor of Pharmacy degree

Benefits

• Generous, flexible vacation policy
• A 401(k) employer match
• Comprehensive health benefits
• Educational assistance
• A variety of leadership and technical development academies to help build your skills and capabilities

Company Overview

Company H1B Sponsorship