Clinical Administrative Pharmacist

🔥 18 hours ago

🎸 Tennessee – Remote

🎸 Tennessee – Remote

💵 $108k - $184k / year

⏰ Full Time

🟢 Junior

💊 Pharmacist

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

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Prime Therapeutics

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1998

🏥 Healthcare

💼 Consulting

🛡️ Insurance

Healthcare • Consulting • Insurance

Prime Therapeutics is a trusted pharmacy solutions provider dedicated to transforming health care through innovation and transparency. The company offers a wide range of services including clinical solutions for improved member outcomes, drug access and affordability, specialty drug management, and condition management for chronic health issues. With over 7,000 employees, Prime Therapeutics aims to challenge norms in the pharmacy industry, providing exceptional experiences and simplifying the complex for millions across the nation. Their mission goes beyond profit, focusing on creating transformative impacts with long-term solutions, utilizing modern technology and holistic approaches in specialty pharmacy management. Owned by mission-driven partners, Prime Therapeutics emphasizes true transparency and conflict-free service, fostering a culture of care and shared purpose in health care.

📋 Description

• Partner with internal stakeholders and clients to develop and maintain project and benefit plan testing scenarios, including utilization management and specialty offerings • Interpret project requests to determine feasibility, document requirements, and provide technical solutions • Conduct testing, including test plan creation, test execution, and User Acceptance Testing for quality assurance • Identify and resolve system issues, perform root-cause analysis, and escalate problems to avoid service disruption • Ensure benefit plans remain in compliance with all regulatory requirements (federal, CMS, state, local, and pharmacy) • Develop, maintain, and verify data for drug utilization and claims adjudication systems to support evidence-based benefit coverage decisions • Support concurrent Drug Utilization Review service messages, table settings, testing and adjudication workflows to ensure accuracy and compliance with established protocols and implementation decisions • Collaborate with leaders to implement client-requested formulary changes and provide subject-matter expertise to internal and external committees • Perform other duties as assigned

🎯 Requirements

• Doctor of Pharmacy (PharmD) or Bachelor of Science Pharmacy Degree • 1 year of work experience in clinical, retail, hospital, or managed care • Current Pharmacist license to practice in the applicable state(s) • Must be eligible to work in the United States without the need for work visa or residency sponsorship • Knowledge of AS400, queries, and Lotus Notes • Strong analytical and problem-solving skills with attention to detail and quality • Ability to manage multiple projects simultaneously under pressure with strict timelines • Skilled in developing and improving process efficiencies • Strong collaboration skills and ability to work in a team-oriented environment • Proficiency with Microsoft Excel and Word

🏖️ Benefits

• Benefits, incentives, and additional compensation (details provided on the employer's Benefits Page) • Equal opportunity and affirmative action employment • Reasonable accommodations for employees with disabilities • Tobacco-free workplace

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