Clinical Review Pharmacist

ChenMed

Clinical Review Pharmacist ensuring access to necessary medications and managing formulary at ChenMed. Completing prior authorizations and overseeing pharmacy services with compliance and quality improvement.

Posted 6/20/2026contract🇺🇸 United StatesJunior💰 $118,062 - $168,658 per yearWebsite

About the role

Key responsibilities & impact

Works to ensure that ChenMed members have access to all medically necessary prescription drugs
Completes prior authorizations for internal expert peer discussions on high-cost medications
Involved in formulary management and clinical pharmacy services
Reviews coverage determinations and appeals in a timely, compliant, and accurate manner
Acts as a liaison between ChenMed and its patients with respect to the clinical guidelines we practice
Serves as the formulary expert for the therapeutic class they are reviewing
Develops, implements and maintains pharmacy cost control and quality initiatives
Contributes to projects aimed at improving STAR ratings, HEDIS, CAHPS, and other quality metrics

Requirements

What you’ll need

Doctorate of Pharmacy (PharmD) required
Must have a License that is in good standing
Minimum one (1) year of pharmacy experience
Minimum one (1) year of utilization review experience preferred
Pharmacy residency training is preferred, but not required
Experience in a managed care setting (HMO, MSO, PBM) is a plus
Medicare Part D or Medicaid experience, along with managed care experience

Benefits

Comp & perks

Great compensation
Comprehensive benefits
Career development and advancement opportunities
Work-life balance

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

formulary managementclinical pharmacy servicesprior authorizationscoverage determinationspharmacy cost controlquality initiativesutilization reviewmanaged care experienceMedicare Part DMedicaid experience

Soft Skills

communicationliaisontimelinesscomplianceaccuracy

Certifications

Doctorate of Pharmacy (PharmD)Pharmacy License