Senior Clinical Pharmacist Reviewer

Piper Companies is seeking a Senior Clinical Pharmacist Reviewer to support a leading organization within the public health and Medicaid services sector for a hybrid contract position based in Raleigh, NC. The Senior Clinical Pharmacist Reviewer will serve as a clinical subject matter expert responsible for reviewing and adjudicating pharmacy prior authorization requests for the North Carolina Medicaid population.

Responsibilities of the Senior Clinical Pharmacist Reviewer include:

· Provide clinical decision-making and guidance for pharmacy prior authorization reviews using North Carolina Medicaid outpatient pharmacy standards.

· Partner closely with pharmacists and pharmacy technicians to ensure accurate and timely evaluation of requests.

· Apply advanced clinical pharmacy knowledge to navigate multiple systems and resolve complex approval scenarios.

· Ensure reviews align with state policies, established criteria, and program expectations.

· Support cross-functional collaboration to enhance workflow efficiency and uphold service quality.

Qualifications for the Senior Clinical Pharmacist Reviewer include: ·

 Active Registered Pharmacist (RPh) license in the state of North Carolina.

· PharmD, MD, or DDS degree.

· At least 8 years of experience in clinical pharmacy practice.

· Prior exposure to pharmacy prior authorization processes and criteria-based adjudication.

· Strong analytical ability and comfort working with multiple computer systems/screens.

Compensation for the Senior Clinical Pharmacist Reviewer:

Salary Range: $90,000-$110,000/year (USD)

Comprehensive Benefits: Medical, Dental, Vision, sick leave if required by law, and 401K

This job opens for applications on 02/19/26. Applications for this job will be accepted for at least 30 days from the posting date.

Keywords: pharmacy operations, clinical pharmacy, prior authorization, Medicaid pharmacy criteria, pharmacist reviewer, medication policy, outpatient pharmacy review, pharmacy adjudication, public health, clinical guidelines

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