Job Description
Note: The job is a remote job and is open to candidates in USA. Prime Therapeutics is a unique PBM focused on connecting care for those they serve. They are seeking a Clinical Pharmacist who will be responsible for processing and documenting Utilization Management requests, collaborating with healthcare providers, and ensuring consistent decision-making across the pharmacist team. Responsibilities Process the clinical evaluation for coverage determination requests for prior authorization (PA) or other utilization management (UM) programs, including quantity limits, step therapy, formulary exception and tier exception; this includes consideration of the denial language and appropriateness of the decision as it pertains to the clinical content of the case and the intent of the individual client’s pre-approved criteria Consult directly with healthcare providers to address non-formulary and clinical product coverage issues Collaborate with team members to ensure consistent decision-making across the pharmacist team Respond to medication-related inquiries via phone, providing accurate information to patients, providers, and clinics regarding medications, formulary options, and coverage questions Other duties as assigned Skills Doctor of Pharmacy (PharmD) or Bachelor of Science Pharmacy Degree 1 years of work experience in clinical, retail, hospital, or managed care Current pharmacist license in good standing with the State Board of Pharmacy Must be eligible to work in the United States without the need for work visa or residency sponsorship Strong verbal and written communication skills Ability to work efficiently with computers and digital tools Managed care experience Company Overview Prime Therapeutics is a trusted pharmacy solutions partner delivering savings, simplicity & support to our customers and members It was founded in 1990, and is headquartered in Eagan, Minnesota, USA, with a workforce of 5001-10000 employees. Its website is