Clinical Pharmacist

Healthfirst

Clinical Pharmacist reviewing prior authorization requests and developing clinical criteria for medications. Collaborating with prescribing physicians and Medical Directors to ensure compliance and quality assurance.

Posted 5/14/2026full-timeNew York City • New York • 🇺🇸 United StatesJunior💰 $103,400 - $149,430 per yearWebsite

About the role

Key responsibilities & impact

Review prior authorization requests for medications
Develop clinical criteria and medical policies for medications
Conduct prior authorization reviews in compliance with CMS and NYSDOH guidelines
Research drug information and maintain drug knowledge for reviews
Review monthly reports and provide feedback on trends and efficiency

Requirements

What you’ll need

Pharmacy degree from an accredited school of pharmacy
Registered Pharmacist in the state of New York with a license in good standing
Minimum of 1 year experience conducting prior authorization reviews
Strong clinical knowledge of pharmaceuticals and disease states in order to conduct prior authorization reviews
Strong clinical writing and verbal skills
Demonstrated critical thinking and problem-solving skills
Knowledge of specialty pharmaceuticals and billing practices in the medical and pharmacy benefits

Benefits

Comp & perks

medical, dental and vision coverage
incentive and recognition programs
life insurance
401k contributions

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

prior authorization reviewsclinical criteria developmentmedical policy developmentdrug information researchclinical knowledge of pharmaceuticalsclinical writingverbal communicationcritical thinkingproblem-solvingknowledge of specialty pharmaceuticals

Soft Skills

strong communication skillsanalytical skills

Certifications

Pharmacy degreeRegistered Pharmacist license