Pyramid Consulting, Inc · 1 month ago
Clinical Pharmacist
United States
Contract
Remote
Senior Level
$50/hr - $58/hr
3+ years expPyramid Consulting, Inc is a leading Health Insurance Industry, and they are seeking a Clinical Pharmacist for a contract opportunity. The role involves reviewing prior authorization requests, providing clinical guidance, and ensuring compliance in pharmacy practices.
ConsultingInformation TechnologyLegalProfessional ServicesSoftwareHuman ResourcesStaffing Agency
Responsibilities
Review prior authorization requests and make determinations for drug products according to member benefits and coverage criteria
Report to utilization review statistics to corporate compliance committees
Review data and summarize daily utilization review numbers
Responsible for tracking compliance of review cases
Provide clinical guidance and support to the assigned pharmacy technicians
Knowledge of drug coding (NDC, GCN, GPI and USC) and NCPDP claims adjudication systems
Review guideline criteria for prior authorization and non-formulary drugs in support of Pharmacy and Therapeutics Committee function and pharmacy benefit design
Ensure and evaluate quality controls and implement opportunities for performance improvement in pharmacy practices
Research drug information to maintain drug knowledge and disease state understanding for application to prior authorization reviews
Participating in comprehensive medication review. Cold calling members and reaching out on non adherence. Advocate for member on adherence gaps. Time that you will be on the phone is going to be 3.5 to 4.5 hours a day
Qualification
Required
Bachelor's degree or advanced degree
3+ years of experience in related field
Current states pharmacy license
Shift/Work Schedule: M-F 8-5 EST
Able to work on computers and has work from home experience
Pharmacist experience
High volume call
Medicare and Medicaid experience
Health Plan
Managed care experience
MTM/CMR
Years of Experience: 3-5
Education/Certifications Required: Pharmacist license for the state
Industry Specific Experience – required, ideal, necessary? Retail, HMO, DSNIP
Preferred
Pharm D
Benefits
Health insurance (medical, dental, vision)
401(k) plan
Paid sick leave (depending on work location)
Company
Pyramid Consulting, Inc
Pyramid Consulting, a global leader in workforce and technology solutions, empowers individuals and organizations to transform and thrive in the most challenging and competitive markets.
5001-10000 employees
H1B Sponsorship
Pyramid Consulting, Inc has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
2%
Represents job field similar to this job
Customer Service and Support
Engineering and Development
Management and Executive
Product Management
Human Resources
Accounting and Finance
Creatives and Design
Sales
Legal and Compliance
Trends of Total Sponsorships
*2026 (65)
2025 (178)
2024 (112)
2023 (95)
2022 (62)
2021 (50)
2020 (117)
Funding
Current Stage
Late StageLeadership Team
Ramesh Maturu
President and Co-Founder
Manish Kaushik
Chief Financial Officer
Recent News
informaconnect.com
2026-03-31
Company data provided by crunchbase