Clinical Pharmacist - Prior Authorization

Location: Virtual eligible within a reasonable commuting distance of offices in Durham, Overland Park, Topeka, Kansas City, Raleigh, or Winston-Salem, United States. Full-time virtual work is available, with required in-person training sessions.

Company

hirify.global is a Fortune 25 healthcare company focused on improving lives and communities and simplifying healthcare.

What you will do

• Research and synthesize detailed clinical data related to pharmaceuticals.
• Prepare and present therapeutic class reviews and drug monographs to the Pharmacy and Therapeutics Committee.
• Review and approve or deny pharmaceutical coverage based on medical necessity criteria where permitted by law and applicable program contracts.
• Coordinate coverage decisions with internal stakeholders and health plan medical directors.
• Provide clinical guidance on prospective, inpatient, and retrospective drug utilization reviews, dosage conversions, and therapeutic interventions.
• Prepare pharmaceutical information for network physicians and support other pharmacists as a clinical resource.

Requirements

• BA or BS in Pharmacy.
• At least 2 years of managed care pharmacy or pharmacy benefit management experience, or a residency in lieu of experience.
• Registered pharmacist with an active, unrestricted state license to practice pharmacy.
• Pharmacist licensure in Kansas or North Carolina is required.
• Strong oral, written, interpersonal, problem-solving, facilitation, and analytical skills.

Nice to have

• PharmD strongly preferred.

Culture & Benefits

• Virtual full-time work with flexibility and autonomy, subject to required in-person training and proximity to a listed office.
• General business hours, Monday through Friday.
• Paid holidays, paid time off, merit increases, and incentive bonus programs.
• Medical, dental, vision, disability, life insurance, and wellness benefits.
• 401(k) with company match, stock purchase plan, and financial education resources.