Clinical Pharmacist Advisor, Medicare

Job overview

The Clinical Pharmacist Advisor, Medicare role is onsite in Woonsocket, RI, with stated pay of $53–$57 per hour. The posting describes a 12-month duration and a set rotation within business hours of 7 a.m.–8 p.m. Eastern, Monday through Friday, and 7 a.m.–4:30 p.m. Eastern on Saturday and Sunday. The role reviews Medicare appeals cases. The pharmacist applies clinical judgment and Medicare guidance to ensure accurate case setup and clinical review. The role documents findings, contacts providers when clinical details are needed, and meets CMS timelines and departmental productivity and quality standards.

What you'll do

• Review internal notes and fax requests for Medicare appeals case information
• ensure accurate case setup and clinical review
• document findings clearly
• contact providers when needed to obtain clinical details
• follow work instructions and Medicare guidelines
• meet CMS timelines and departmental productivity and quality standards
• use drug compendia and CMS guidance
• participate in development discussions and receive supervisor feedback.

What we're looking for

Skills & competencies

clinical pharmacist advisor

medicare

woonsocket ri

us tech solutions

clinical review

medicare appeals

pharmacist license

pharmd

cms guidelines

case documentation

weekend rotation

$53–$57/hr

Work arrangement

• Weekend coverage required

Why this role

A pharmacy bachelor’s degree or PharmD and an active pharmacist license in the state of residence are required; managed care or PBM experience is preferred.

About the employer

US Tech Solutions, Inc. is hiring for this role. Industry: Offices of Physicians (except Mental Health Specialists). Sector: 62.