Senior Clinical Advisor, Pharmacy Operations
Compensation
$125k – $160k /yr
Employment type
Full-time
Work setting
On-site
Location
Southborough, MA
Schedule
Day shift
Posted
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Job overview
The Senior Clinical Advisor role is listed in Southborough, MA, and pays $125,000–$160,000 annually. RxAdvance’s mission is to transform healthcare through medical and pharmacy benefit management solutions. The advisor applies pharmacy expertise to prior authorization operations, clinical policy, technology, and quality programs. The role supports accurate coverage decisions and efficient pharmacy benefit processes through clinical review, research, analysis, and collaboration with pharmacy operations and clients.
What you'll do
- Perform clinical reviews of prior authorization, step therapy, quantity limit, and other pharmacy utilization requests
- make coverage determinations and handle appeals under applicable criteria and regulations
- support formulary development and maintenance
- research utilization management strategies
- advise on client requirements and technical specifications
- analyze reporting and quality data
- support audits and continuous improvement.
What we're looking for
- Skills & competencies
- senior clinical advisorpharmacypharmacy operationssouthborough marxadvanceprior authorizationformulary managementcoverage determinationsappealsmedicare part dpharmd required$125k–$160k annually
- Work arrangement
- Weekend coverage required
Why this role
Combines pharmacist clinical review with pharmacy policy, formulary, automation, and client consultation responsibilities.
About the employer
Rxadvance Corporation is hiring for this role. Industry: Direct Health and Medical Insurance Carriers. Sector: 52.
Additional details
- Industry sector
- 52
- Industry
- Direct Health and Medical Insurance Carriers
- Occupation code
- 29-1051.00
You'll be redirected to the employer's application page.
Listing ID: 8852dfe7-bf8c-485c-9522-425edbe8601f