Principal Clinical Pharmacist- Remote

Summary

The Principal Clinical Pharmacist supports the successful build, configuration, testing, and ongoing quality assurance of prior authorization (PA) programs and related pharmacy clinical workflows. This role is primarily responsible for translating approved clinical policies, coverage criteria, client requirements, and operational needs into accurate PA build requirements, configuration inputs, test scenarios, validation activities, and release-ready solutions. This is a hands-on role that requires direct involvement in PA build requirements, configuration validation, QA testing, defect resolution, and production readiness activities. As a senior clinical subject matter expert, the position partners closely with clinical, operations, technology, product, reporting, and client-facing teams to ensure PA workflows are configured correctly, tested thoroughly, and ready for compliant operational use. The role also contributes to broader clinical program operations over time, including drug utilization review (DUR), preferred drug list (PDL) support, P&T Committee and DUR Board activities, academic detailing, population health, provider engagement, quality improvement, and continuous program improvement.

Your role in our mission

What we're looking for

• Active pharmacist license in good standing required.
• PharmD preferred; Bachelor of Pharmacy degree accepted.
• Preferred: 7 or more years of progressive experience in clinical pharmacy, managed care, PBM, Medicaid pharmacy, prior authorization, pharmacy operations, or related clinical program operations.
• Hands-on experience supporting prior authorization builds, clinical criteria implementation, pharmacy benefit or PA configuration, workflow setup, operational requirements, or system-enabled clinical programs strongly preferred.
• Experience participating directly in QA, unit testing, system integration testing, user acceptance testing, regression testing, defect review, production validation, or implementation readiness activities strongly preferred.
• Experience translating clinical policy, coverage criteria, client requirements, regulatory expectations, and operational workflows into build requirements, configuration inputs, test cases, and validation documentation preferred.
• Strong knowledge of Medicaid pharmacy programs, managed care pharmacy, PBM operations, state and federal requirements, regulatory expectations, and pharmacy-related Medicaid requirements preferred.
• Experience supporting P&T Committee activities, DUR Board activities, PDL management, DUR initiatives, academic detailing, population health, clinical quality, provider outreach, or clinical program improvement preferred.
• Experience working cross-functionally with clinical, operations, configuration, technology, reporting, product, account management, client-facing teams, and leadership stakeholders.
• Proficiency with Microsoft Office products and ability to quickly learn proprietary systems, workflow tools, reporting platforms, and configuration or testing tools.

What you should expect in this role