Prior Authorization Clinical Pharmacist

Location: Virtual full-time role with required in-person training and commuting distance from an hirify.global posting location; must be located in a U.S. state or territory when conducting utilization review or appeals consideration. Posting locations include Overland Park, Kansas; Miami, Florida; Atlanta, Georgia; Topeka, Kansas; Louisville, Kentucky; Durham and Winston-Salem, North Carolina; Nashville, Tennessee; and Grand Prairie, Texas.

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 pharmaceutical data.
• 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 contracts.
• Support prospective, inpatient, and retrospective drug utilization reviews, dosage conversions, and therapeutic interventions.
• Develop drug information and evidence-based recommendations for network physicians and clinical teams.

Requirements

• Bachelor’s degree in Pharmacy.
• At least two years of managed care pharmacy or PBM experience, or a residency in lieu of work experience.
• Registered Pharmacist status with a current unrestricted license in the applicable state.
• Must be located in a U.S. state or territory when conducting utilization review or appeals consideration.
• Strong oral, written, interpersonal communication, problem-solving, facilitation, and analytical skills.

Nice to have

• Active unrestricted Registered Pharmacist license in Kansas.
• PharmD degree.
• PBM, prior authorization, or specialty medication experience.

Culture & Benefits

• Virtual work arrangement with flexibility and autonomy, subject to in-person training and location requirements.
• 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.
• COVID-19 and influenza vaccination may be required for certain patient- or member-facing roles.