[Hiring] Pharmacist, Advisor @Gainwell Technologies LLC

Role Description

As a Prior Authorization Pharmacist, you will review clinical documentation and Preferred Drug List criteria to determine the appropriateness of medication therapy and prior authorization requests. You will collaborate with internal and external stakeholders to evaluate and continuously improve utilization management strategies, clinical programs, and pharmacy operations.

• Conduct clinical evaluations of medication therapy and review prior authorization requests using established clinical guidelines and Preferred Drug List criteria.
• Participate in peer-to-peer discussions with medical providers regarding prior authorization reviews, clinical determinations, and appropriate medication therapy.
• Provide clinical pharmacy consultations and interventions, including reviewing prior authorization data to identify prescribing trends and opportunities for intervention.
• Support Clinical Call Center and Prior Authorization operations by providing pharmacy expertise and assisting with communications to members, providers, and internal teams.
• Collaborate with Medical Directors, Clinical Pharmacists, Clinical Specialty Pharmacists, and other stakeholders to maintain clinical integrity and advance pharmacy program best practices.
• Identify and support quality and operational improvements that enhance the efficiency and effectiveness of pharmacy programs and services.

Qualifications

• Doctor of Pharmacy (PharmD) or Bachelor of Science in Pharmacy with relevant specialty experience.
• Active, unrestricted pharmacist license in the applicable state.
• At least four years of clinical pharmacy experience, including clinical reviews using recognized drug compendia, clinical guidelines, and clinical trial data.
• Strong analytical, research, communication, and problem-solving skills, with the ability to translate clinical findings into practical recommendations.
• Strong collaboration and team skills, with proficiency in Microsoft Office and the ability to quickly learn proprietary systems.

Requirements

• This position is remote.
• Work hours: Eastern Time Zone.
• The deadline to submit applications for this posting is December 31, 2026.
• The pay range for this position is 90,900 - 129,900 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors.

Benefits

• Generous, flexible vacation policy.
• 401(k) employer match.
• Comprehensive health benefits.
• Educational assistance.
• A variety of leadership and technical development academies to help build your skills and capabilities.