Clinical Pharmacist - 100% Remote

OverviewWe are seeking a clinically focused healthcare professional to support medication authorization and appeals reviews. This role is responsible for evaluating drug coverage requests, collaborating with prescribing providers, and applying clinical expertise to promote safe and appropriate pharmaceutical use.ResponsibilitiesReview and render determinations on authorization requests and appeals for specialty, non-specialty, and physician-administered medications.Conduct peer-to-peer discussions with prescribing providers to review clinical rationale and support adverse determination decisions.Participate in clinical quality audits and inter-rater reliability assessments.Provide support for internal escalations and clinical inquiries.Apply clinical knowledge to help ensure the appropriate, safe, and effective use of medications.Maintain compliance with all applicable healthcare regulations and standards.Perform additional duties as assigned.Required QualificationsExperience reviewing medication authorizations and appeals.Strong clinical knowledge of specialty and non-specialty pharmaceuticals.Ability to evaluate clinical documentation and make evidence-based coverage determinations.Excellent communication skills, including the ability to conduct peer-to-peer discussions with healthcare providers.Strong attention to detail and commitment to quality and regulatory compliance.Preferred QualificationsExperience participating in clinical quality audits and inter-rater reliability reviews.Knowledge of physician-administered medication review processes.Experience supporting escalations and cross-functional clinical teams