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Clinical Pharmacist 1

Spectraforce Technologies
United States, North Carolina, Raleigh
500 West Peace Street (Show on map)
Jun 24, 2025

Position Title: Clinical Pharmacist 1

Work Location: Remote

Assignment Duration: 6 months

Work Schedule: 10 am - 6:30 pm EST, OT possible

Position Summary:

* Define and develop standard and custom formularies for assigned plan.

Background & Context:

* This team reviews medication prior authorization requests and coverage determinations for the Medicaid, Medicare and Health Exchange lines of business.

Key Responsibilities:

* Develop clinical criteria for medications, recommend plan design changes, and clinical programs to be initiated

* Monitor prior authorization requests

* Provide clinical support to internal departments and address clinical related questions

* Ensure appropriate quality controls and initiates opportunities for performance improvement in pharmacy/practice

* Develop and implement programs designed to impact DUR for both Medicaid and Medicare

* Develop, implement, and maintain policies and procedures for the pharmacy department

* Participate in the coordination of the Medicare MTM program

* Assist case management team with members including clinical rounds presentations

Qualification & Experience:

* Bachelor's degree or advanced degree (Pharm.D., M.S.) in pharmacy

* 2+ years of mail order, retail, hospital or managed care pharmacy experience OR 1+ years of pharmacy residency program experience

* Current state's Pharmacist license with no restrictions





  • Walk me through the day-to-day responsibilities and a description of the project (Outside of the Workday JD).
  • What are the performance expectations/metrics?
  • What makes this role unique?


A typical day consists of reviewing 140 to 160 clinical prior authorizations or coverage determiantions
Candidate Requirements
Education/Certification Required: Bachelors / PharmD Preferred:
Licensure Required: Current states pharmacist license Preferred:
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