Clinical Pharmacist

Piper Companies is seeking a Clinical Pharmacist to join a Medicare Case Management Team supporting comprehensive medication review activities. The Clinical Pharmacist will conduct in-depth case evaluations, support utilization review processes, and collaborate closely with pharmacy technicians. This position offers the ability to work from home while contributing to clinical decision-making and quality improvement initiatives.

• Bachelor’s degree or advanced degree in Pharmacy
• 3+ years of experience as a Clinical Pharmacist or in a related field
• Active state pharmacy license
• Prior work‑from‑home experience
• Strong understanding of Medicare case management practices
• Knowledge of drug coding (NDC, GCN, GPI, USC) and NCPDP claims adjudication systems
• Ability to review guideline criteria for prior authorization and non‑formulary medications
• Excellent communication skills for outbound and inbound call interactions
• Experience reviewing drug information and applying it to utilization review decisions

• Conduct comprehensive case reviews and medication evaluations for members
• Perform determinations for drug products based on benefit coverage and clinical criteria
• Complete both inbound and outbound member calls; calls will be recorded and audited for quality
• Report utilization review data to corporate compliance committees
• Track and document compliance of review cases
• Summarize daily utilization review metrics and trends
• Provide clinical guidance and support to pharmacy technicians
• Review guideline criteria in support of Pharmacy & Therapeutics Committee activities and benefit design
• Identify and implement performance improvement opportunities within pharmacy processes
• Research drug information to maintain current clinical knowledge and disease-state expertise

• Remote work environment
• Full‑time position
• Full Benefits
• Compensation: $110,000–$116,000