Clinical Pharmacist Advisor- Remote
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AI Summary
It takes great medical minds to create powerful solutions that solve some of healthcare’s most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you’ve honed your career in a fast-moving medical environment. While Gainwell operates with a sense of urgency, you’ll have the opportunity to work more flexible hours. And working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values work-life balance, continuous learning, and career development.
Summary
The account Pharmacist will work directly with the account Pharmacy Manager and the state Pharmacy Program Director to operate the Medicaid prescription drug program within state budget and according to legislative requirements and laws.
Your role in our mission
- Conduct clinical evaluations of medication therapy and review prior authorization requests using PDL criteria
- Facilitate peer-to-peer discussions with providers regarding prior authorization decisions
- Collaborate with prescribers and internal teams on clinical consultations and targeted interventions
- Support call center operations by providing clinical guidance and assisting with provider/member communicationsServe as a subject matter expert for pharmacy-related questions across the organization
- Contribute to quality improvement initiatives and program enhancements
- Maintain clinical expertise and collaborate with cross-functional teams on pharmacy best practices
- Provide input on drug utilization reviews and formulary managementSupport Medicaid Drug Rebate Program operations and assist with state pharmacy audits
- Deliver training to pharmacy providers and contribute to reporting and administrative activities
What we're looking for
- Registered Pharmacist with respective State Licensure
- PharmD (preferred) or Bachelor of Pharmacy degree
- At least 5 years of experience working in a pharmacy setting or pharmacy benefit management system.
- Knowledge of Medicaid at the state and/or federal level.
- Knowledge of pharmacy-related aspects of Medicaid.
- Working knowledge of HIPAA regulations and requirements.
What you should expect in this role
- Remote opportunity within the United States
- Travel: 0–10%
The pay range for this position is $115,000.00 - $150,000.00 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. Put your passion to work at Gainwell. You’ll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits, and educational assistance. We also have a variety of leadership and technical development academies to help build your skills and capabilities.
We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Build your career with Gainwell, an industry leader. You’ll be joining a company where collaboration, innovation, and inclusion fuel our growth. Learn more about Gainwell at our company website and visit our Careers site for all available job role openings.
Gainwell Technologies is an Equal Opportunity Employer, where all qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical condition), age, sexual orientation, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. Gainwell Technologies defines “wages” and “wage rates” to include “all forms of pay, including, but not limited to, salary, overtime pay, bonuses, stock, stock options, profit sharing and bonus plans, life insurance, vacation and holiday pay, cleaning or gasoline allowances, hotel accommodations, reimbursement for travel expenses, and benefits.
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