Remote Clinical Pharmacist I

📋 Description

• • As a Remote Clinical Pharmacist I at Alignment Healthcare, you will play a critical role in ensuring clinically appropriate and compliant coverage determinations for Medicare Advantage members, directly impacting the health and safety of seniors and chronically ill populations.
• • Day to day, you will review Part D coverage determinations and appeals, conduct comprehensive medication reviews via telephone for high-risk members, support pharmacy quality improvement initiatives tied to Medicare Star Ratings and HEDIS measures, and maintain accurate documentation in compliance with CMS regulations.
• • You will join a mission-driven, fast-growing team at Alignment Health dedicated to transforming care for seniors, where innovation and compassion are central to improving member outcomes and plan performance.
• • In this role, you will deepen your expertise in Medicare Part D operations, Medication Therapy Management, and regulatory compliance while contributing to meaningful clinical initiatives that enhance adherence, reduce high-risk medication use, and elevate plan quality scores.