Clinical Care Prior Authorization Pharmacist (Temp, Temp-to-hire)

Active, unrestricted, pharmacist license

Bachelor’s or Doctor of Pharmacy degree

Minimum of 2 years of pharmacy practice experience

Experience in managed care or pharmacy benefit management (PBM)

Strong communication, writing, and organizational skills

Ability to manage multiple priorities in a high-volume, metric-driven environment

The Clinical Care Pharmacist plays a vital role in promoting safe, effective, and appropriate medication use. This position is responsible for reviewing prior authorization requests, supporting clinical programs, and providing expert guidance to members, providers, and pharmacies. The role combines clinical decision-making with a strong focus on service excellence in a fast-paced, collaborative environment.

Review and make timely, evidence-based decisions on prior authorizations, appeals, and override requests using clinical guidelines and benefit criteria.

Ensure compliance with federal, state, and internal regulations across Commercial, Exchange, Medicare, and Medicaid plans.

Accurately document clinical decisions and maintain thorough records in accordance with regulatory and accreditation (URAC/NCQA) utilization review standards.

Provide clear, empathetic support to members, prescribers, and pharmacies by responding to clinical inquiries via phone, demonstrating professionalism, active listening, and a patient-centered approach.