Clinical Pharmacist Advisor Medicare

Date Posted: 09/08/2026 Hiring Organization: Rose International Position Number: 507063 Industry: Pharmaceutical/Healthcare Job Title: Clinical Pharmacist Advisor Medicare Job Location: Remote, USA Work Model: Remote Shift: 8-hour shift between 7 AM to 8PM EST Employment Type: Temporary FT/PT: Full-Time Estimated Duration (In months): 12 Min Hourly Rate($): 50.00 Max Hourly Rate($): 53.00 Must Have Skills/Attributes: Clinical, Medicare, Pharmacy Experience Desired: Clinical pharmacy experience with Medicare Part D requests and clinical review (3+ yrs); Experience applying clinical guidelines, drug compendia, and regulatory requirements (2+ yrs); Data entry and experience navigating multiple computer applications (2+ yrs); Proficiency with Microsoft Excel and Word (2+ yrs) Required Minimum Education: Bachelor’s Degree Preferred Education: Ph.D / Doctorate Required Certifications/Licenses: Active Pharmacist license in good standing in the state of residence **C2C is not available** Job Description Required Education: Bachelor’s degree in Pharmacy or PharmD Required License/Certification Active Pharmacist license in good standing in the state of residence Required Qualifications/Skills/Experience Data entry experience Strong computer literacy, including Microsoft Excel and Word Ability to navigate multiple computer applications using two screens Ability to work independently in a productivity-driven environment Ability to sit and focus without interruptions for the duration of the shift Ability to maintain a dedicated, quiet, separate workspace for remote work Strong attention to detail and accuracy Ability to meet productivity and quality standards Preferred Qualifications/Skills/Experience Previous experience in a Managed Care/PBM environment Knowledge of Microsoft Access, PowerPoint, and Visio Previous experience with Medicare Part D Experience reviewing clinical information and applying Medicare guidelines Clinical Pharmacist Advisor Medicare Overview The Clinical Pharmacist Advisor Medicare supports Medicare Part D members and providers with requests related to pharmacy benefits The role is responsible for accurately setting up cases, reviewing clinical information for decision-making, and conducting outreach to providers when additional information is needed The position requires timely and accurate documentation while ensuring compliance with Medicare guidelines, CMS requirements, drug compendia, work instructions, and departmental quality and productivity standards The pharmacist will use clinical judgment and pharmacy knowledge to support appropriate case processing and decisions This is a fully remote, work-from-home position requiring a dedicated, quiet workspace and reliable wired internet Candidates must be licensed pharmacists in good standing in their state of residence and comfortable working independently in a highly structured, data-entry and productivity-focused environment The position also includes virtual interviews and requires candidates to remain on camera during training, supervisor meetings, and team meetings Job Duties Ensure accurate setup and processing of Medicare appeals cases Review internal notes and fax requests for pertinent clinical information Review clinical information to support appropriate case decisions Contact providers to obtain additional clinical information when necessary Apply Medicare guidelines, CMS requirements, drug compendia, and applicable work instructions Complete accurate and timely documentation of Medicare Part D requests Ensure compliance with required regulatory timelines Meet departmental productivity and quality standards Participate in development discussions and incorporate supervisor feedback Support continuous improvement initiatives #CV1 **Only those lawfully authorized to work in the designated country associated with the position will be considered.****Please note that all Position start dates and duration are estimates and may be reduced or lengthened based upon a client’s business needs and requirements.** Benefits For information and details on employment benefits offered with this position, please visit here. Should you have any questions/concerns, please contact our HR Department via our secure website. California Pay Equity For information and details on pay equity laws in California, please visit the State of California Department of Industrial Relations' website here. Rose International is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender (expression or identity), national origin, arrest and conviction records, disability, veteran status or any other characteristic protected by law. Positions located in San Francisco and Los Angeles, California will be administered in accordance with their respective Fair Chance Ordinances. If you need assistance in completing this application, or during any phase of the application, interview, hiring, or employment process, whether due to a disability or otherwise, please contact our HR Department. Rose International has an official agreement (ID #132522), effective June 30, 2008, with the U.S. Department of Homeland Security, U.S. Citizenship and Immigration Services, Employment Verification Program (E-Verify). (Posting required by OCGA 13/10-91.).