Clinical Pharmacist

Piper Companies is seeking a Clinical Pharmacist to join a Medicare Case Management Team supporting comprehensive medication review activities. The Clinical Pharmacist will conduct in‑depth case evaluations, support utilization review processes, and collaborate closely with pharmacy technicians. This position offers the ability to work from home while contributing to clinical decision-making and quality improvement initiatives.

Requirements

• Bachelor’s degree or advanced degree in Pharmacy
• 3+ years of experience as a Clinical Pharmacist or in a related field
• Active state pharmacy license
• Prior work‑from‑home experience
• Strong understanding of Medicare case management practices
• Knowledge of drug coding (NDC, GCN, GPI, USC) and NCPDP claims adjudication systems
• Ability to review guideline criteria for prior authorization and non‑formulary medications
• Excellent communication skills for outbound and inbound call interactions
• Experience reviewing drug information and applying it to utilization review decisions

Responsibilities

• Conduct comprehensive case reviews and medication evaluations for members
• Perform determinations for drug products based on benefit coverage and clinical criteria
• Complete both inbound and outbound member calls; calls will be recorded and audited for quality
• Report utilization review data to corporate compliance committees
• Track and document compliance of review cases
• Summarize daily utilization review metrics and trends
• Provide clinical guidance and support to pharmacy technicians
• Review guideline criteria in support of Pharmacy & Therapeutics Committee activities and benefit design
• Identify and implement performance improvement opportunities within pharmacy processes
• Research drug information to maintain current clinical knowledge and disease-state expertise

Additional Information

• Remote work environment
• Full‑time position
• Full Benefits
• Compensation: $110,000–$116,000