Job Details
Licensed Pharmacist - Medicare Part D
2026-04-13 Virtual Vocations Lafayette,LA
Description:
A company is looking for a Pharmacist - Medicare Part D - Clinical Review Specialist.Key ResponsibilitiesSupport Medicare Part D members and providers with pharmacy benefit and coverage determination requestsEnsure accurate case setup and complete clinical review of Medicare appeals in compliance with CMS guidelinesReview clinical information and make appropriate determinations based on drug compendia and clinical judgmentRequired QualificationsLicensed PharmacistKnowledge of Medicare Part D regulations, including coverage determinations and appeals (CMS guidelines)Experience with PBMS, Utilization Management, or Prior Authorization review highly preferred