[Remote] Pharmacist - Clinical Pharmacist Advisor Medicare

Note: The job is a remote job and is open to candidates in USA. LanceSoft, Inc. is a leading staffing firm in the US, and they are seeking a Clinical Pharmacist Advisor Medicare to support Medicare Part D members and providers with pharmacy benefit requests. The role involves ensuring accurate case setup, reviewing clinical information, and complying with Medicare guidelines while providing exceptional service. Responsibilities • Ensure the accuracy of case setup and clinical review of Medicare appeals cases by thoroughly reviewing internal notes or fax requests for pertinent information. • Provide clear and concise documentation and contact providers when necessary to obtain clinical details for case decisions. • Adhere to work instructions and Medicare guidelines to ensure proper case processing. • Ensure compliance with CMS-mandated timelines, as well as departmental productivity and quality standards. • Apply clinical judgment and knowledge effectively, utilizing drug compendia resources, evolving work instructions, and CMS Medicare guidance. • Participate in development discussions and receive feedback from the direct supervisor to support continuous improvement. Skills • Must provide internet speed test on the resume (INCLUDE SCREEN SHOT) - www.speedtest.net (make sure both download/upload speed is shown) • Must have active license in the state of residence listed on the resume (INCLUDE SCREENSHOT OF LICENSE. MUST INCLUDE DATES/NAME/STATE/ETC. TO SHOW IT IS ACTIVE) • Licensed Registered Pharmacist in state of residence • Must be computer literate – knowledge of Excel and Word • Attendance is extremely important, especially during the initial 8-10 weeks of training. The new hire must be available M-F from 9am-5:30pm EST for the first 8 weeks (no vacation time planned). • After training, shifts will be assigned based on business needs and will include either 1 weekend day, or a weekend rotation. • This is a work from home (WFH) position for which you must have a dedicated quiet, separate space to work. • Must be able to sit and focus on work for the duration of shift. • Data entry and navigating multiple computer applications while utilizing two screens is the primary function of job (possible outbound calls needed). A job history demonstrating this is recommended. • Do you have an active Pharmacist license in good standing in the state you live in? MUST INCLUDE SCREENSHOT OF ACTIVE PHARMACY LICENSE AT TOP OF RESUME. • Are you able to work independently and successfully in a data entry, productivity driven role? • As a company we strive for a team that is engaged and positive so candidates that demonstrate this would be ideal. • Knowledge of Access, Power Point, and Visio is preferable. • Previous experience in Managed Care/PBM environment (preferred) Benefits • Four options of medical Insurance • Dental and Vision Insurance • 401k Contributions • Critical Illness Insurance • Voluntary Permanent Life Insurance • Accident Insurance • Other Employee Perks Company Overview • Established in 2000, LanceSoft is a pioneer in delivering top-notch Global Workforce Solutions and IT Services to a diverse clientele. It was founded in 2000, and is headquartered in Herndon, Virginia, USA, with a workforce of 5001-10000 employees. Its website is http://www.lancesoft.com/. Company H1B Sponsorship • LanceSoft, Inc. has a track record of offering H1B sponsorships, with 46 in 2025, 32 in 2024, 23 in 2023, 25 in 2022, 60 in 2021, 80 in 2020. Please note that this does not guarantee sponsorship for this specific role. Apply tot his job Apply To this Job