Clinical Services Pharmacist

Job overview

The Clinical Services Pharmacist role follows a hybrid work model with required onsite workdays at the Puerto Rico location; the listing identifies the location as 00909, PR. Compensation is not specified. The pharmacist supports Abarca Health’s Clinical group and its medication and health-outcome programs for client beneficiaries. The role evaluates coverage requests and conducts medication reviews to identify, resolve, and prevent medication-related problems. It contributes clinical recommendations, program quality, regulatory compliance, and coordinated support for beneficiaries and internal teams.

What you'll do

• Conduct comprehensive and targeted medication reviews and document care
• use prescription and medical claims data and formulary information to make clinical recommendations
• identify care gaps, high-risk medications, interactions, substitutions, and adherence issues
• collaborate with Health Educators and Case Managers
• support clinical programs and CMS Medicare STAR and Medicaid initiatives
• participate in audits and the Pharmacy and Therapeutics Committee
• develop clinical policies and procedures
• evaluate coverage determinations and appeals
• provide drug information to PA Customer Service Teams
• support CMS and URAC compliance.

What we're looking for

Skills & competencies

clinical services pharmacist

abarca health

hybrid

puerto rico

medication therapy management

medication reviews

coverage determinations

clinical programs

pharmacy benefits

puerto rico pharmacist license

on-call may apply

Work arrangement

• Weekend coverage required

Why this role

Requires a doctoral pharmacy degree, an active Puerto Rico pharmacy license, and three or more years of clinical operations, clinical programs, or medication therapy management experience. The role may require on-call availability, including evenings, weekends, and holidays, if applicable.

About the employer

Abarca Health LLC is hiring for this role. Industry: Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds. Sector: 52.