Clinical Review Pharmacist

Job overview

The Clinical Review Pharmacist role is remote across the United States; the listing location is Tampa, FL. The posting lists base pay ranges of $64–$66 per hour for Zone A and $63–$65 per hour for Zones B and C; Florida is included in Zone C. SmithRx’s clinical team supports its pharmacy benefit management programs and aims to improve member and client outcomes. The pharmacist reviews prior authorizations and appeals using clinical guidelines and benefit criteria, documents decisions, and responds to clinical questions from members, prescribers, and pharmacies. The role supports compliant utilization review and the development of clinical offerings.

What you'll do

• Review prior authorizations and appeals and make timely, evidence-based decisions
• comply with applicable regulations
• document decisions according to utilization review standards
• respond to clinical inquiries from members, prescribers, and pharmacies
• stay current on guidelines, policies, and regulatory changes
• follow HIPAA procedures
• identify and report potential fraud, waste, and abuse
• support team training as needed
• assist with projects and process improvements.

What we're looking for

Skills & competencies

clinical review pharmacist

pharmacy

prior authorization

clinical appeals

utilization management

pharmacy benefit management

remote us

tampa fl listing

smithrx

$63–$66 per hour by zone

Work arrangement

• Weekend coverage required

Benefits & perks

• Time off programs, medical, dental and vision coverage, mental health support, paid parental leave, life and disability insurance, and 401(k).

Why this role

Remote US role with pay zones based on work location. The posting requires a PharmD or Bachelor of Science in Pharmacy from an ACPE-accredited school, an active unrestricted pharmacist license, and at least two years of pharmacy practice experience. After-hours, weekend, and holiday availability is required on a rotating or fixed schedule.

About the employer

SmithRx is hiring for this role. Industry: Direct Health and Medical Insurance Carriers. Sector: 52.