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Actalent
Pharmacist
Career Insights for Clinical Pharmacist
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What they do
A Clinical Pharmacist provides medications to patients and educates patients and physicians on the proper use of medications. Works in a clinical setting, directly with physicians and other health professionals, often granted patient care privileges and responsibility of assisting in patient care management. Usually requires a Doctor of Pharmacy degree.
$136,498 / year median in the U.S.
-0% projected decline
Job Description
Description The Clinical Pharmacist supports the review of prior authorization and appeal requests by evaluating clinical documentation and making coverage determinations based on established criteria. This role involves collaborating with prescribers, pharmacies, and internal teams to obtain necessary clinical information, document decisions, and communicate outcomes. The pharmacist ensures reviews are completed accurately, efficiently, and in compliance with applicable regulatory and client requirements while contributing to process improvements within the prior authorization program. Additional Skills & Qualifications Experience working with multiple PBM platforms and payer-specific prior authorization workflows Familiarity with medical benefit vs. pharmacy benefit coverage determinations Exposure to appeals processing (first-level, second-level, or external review submissions) Working knowledge of managed care, utilization management, or health plan operations Experience communicating clinical rationale to providers, pharmacies, or members in written or verbal form Comfort reviewing specialty medications (e.g., biologics, oncology, immunology, rare disease) Understanding of CMS, state-level, and payer regulatory requirements related to prior authorization Experience using workflow, ticketing, or case management systems for clinical reviews Ability to identify process inefficiencies and contribute to workflow or policy improvements Experience supporting high-volume or metrics-driven environments while maintaining quality standards Job Type & Location This is a Contract position based out of Birmingham, AL. Pay and Benefits The pay range for this position is $50.00 - $55.00/hr. Individual compensation offered for this position within this range will depend on many factors, including qualifications, skills, relevant experience, job knowledge, geographic location, internal equity, and other pertinent job-related factors. Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following:
- Medical, dental & vision
- Critical Illness, Accident, and Hospital
- 401(k) Retirement Plan - Pre-tax and Roth post-tax contributions available
- Life Insurance (Voluntary Life & AD&D for the employee and dependents)
- Short and long-term disability
- Health Spending Account (HSA)
- Transportation benefits
- Employee Assistance Program
- Time Off/Leave (PTO, Vacation or Sick Leave) Workplace Type This is a fully remote position.
San Francisco Fair Chance Ordinance:
Pursuant to the San Francisco Fair Chance Ordinance, for all positions located in the city and county of San Francisco, we will consider for employment qualified applicants with arrest and conviction records.Massachusetts Lie Detector:
It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability. Use of Artificial Intelligence (AI): We may use Artificial Intelligence (AI) to support parts of our hiring process, including sourcing, screening, and evaluating candidates. AI helps assess applications and qualifications, but final decisions are made by our hiring team. By applying, you acknowledge and agree that your application may be reviewed using AI tools.Benefits
- Paid Time Off (PTO)
- Sick Leave
- 401(k) Plans
- Other Retirement and Savings