Clinical Pharmacist
$118,000–$140,000 year
Hybrid · Sacramento, California, United States
Job Summary
Clinical Pharmacist position supporting Prior Authorization Operations in a managed care environment. Deliver clinical excellence through comprehensive reviews of PA, exception, and appeal requests; ensure regulatory compliance (NCQA, DMHC, Board of Pharmacy, Knox-Keene); collaborate with internal teams and network providers; contribute to formulary management and PBM strategies; participate in workflow optimization and quality improvement; provide education to providers; assist with regulatory audits and accreditation; support training and system readiness; engage in cross-coverage for timely case completion. Requires PharmD or equivalent, active CA license, and 4+ years of pharmacy experience with preference for managed care exposure.
Required Qualifications
- Doctor of Pharmacy (PharmD) or equivalent required
- Active, unrestricted California Pharmacist license in good standing
- Minimum 4 years of pharmacy experience (retail, hospital, or mail order)
- 2+ years of managed care, PBM, or health plan experience preferred
- Experience with prior authorization review and utilization management
- Familiarity with formulary management and P&T committee processes preferred
- Proficiency in evaluating clinical literature and drug databases (e.g., UpToDate, DrugDex, NCCN)
- Strong computer skills including Microsoft Office and pharmacy systems
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