Clinical Pharmacist

Job overview

The Clinical Pharmacist role is remote across the United States; pay is $55–$58 per hour. The position is recruited by Pyramid Consulting for a client in the health insurance industry. The pharmacist reviews prior authorization requests against member benefits and coverage criteria, supports utilization review reporting, and provides guidance to pharmacy technicians. Clinical review and quality controls help ensure consistent coverage decisions and pharmacy practices.

What you'll do

• Review prior authorization requests and determine coverage according to member benefits and criteria
• report utilization review statistics
• summarize daily review data and track case compliance
• provide clinical guidance to pharmacy technicians
• use drug coding and claims adjudication systems
• review criteria for prior authorization and non-formulary drugs
• identify quality and performance improvement opportunities
• research drug information.

What we're looking for

Skills & competencies

clinical pharmacist

remote

united states

pyramid consulting

prior authorization

utilization review

drug coverage criteria

pharmacy technician support

ncpdp claims

current state pharmacy license

$55–$58/hour

health insurance industry

Work arrangement

• Weekend coverage required

Benefits & perks

• Medical, dental, and vision insurance
• 401(k)
• paid sick leave depending on work location.

Why this role

Six-month-plus contract opportunity with long-term potential; requires three or more years of related experience, a bachelor’s or advanced degree, and a current state pharmacy license.

About the employer

Pyramid Consulting, Inc is hiring for this role. Industry: Direct Health and Medical Insurance Carriers. Sector: 52.