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General Information

Work Location: Los Angeles, CA, USA
Onsite or Remote
Flexible Hybrid
Work Schedule
Monday-Friday, 8:00am-5:00pm PST
Posted Date
08/12/2025
Salary Range: $86.32 - 107.31 Hourly
Employment Type
2 - Staff: Career
Duration
Indefinite
Job #
26110

Primary Duties and Responsibilities

As our Medicare Advantage Staff Pharmacist, supporting the pharmacy department in managing the Medicare Advantage Part D Prescription Benefit. You’ll ensure compliance with Medicare regulations, optimize operational efficiency, and maintain financial and clinical quality.
In this role, you will:

• Oversee delegated entities and ensure compliance
• Manage claims processing and formulary utilization
• Analyze drug utilization trends to identify cost-saving opportunities
• Coordinate member communications
• Collaborate closely with delegated medical groups
• Lead initiatives to improve medication adherence and STAR ratings
• Ensure timely and accurate Medicare reporting
• Support the development of Medicare Part B strategy development

This role serves as a vital pharmacy resource, focusing on PBM coordination and cross-department collaboration as a subject matter expert in Medicare Part D and pharmacy topics.

Salary Range: $86.32/hour-$107.31/hour

Job Qualifications

We’re seeking a dedicated clinical professional with:

  • PharmD degree and current, unrestricted CA Pharmacy License
  • Minimum of 7 years of relevant experience, or 5+ years of experience with residency, required
  • At least 3 years of Medicare Experience, including CMS compliance, required
  • Minimum 3 years of experience in PBM or health plan settings, required
  • 3+ years of experience collaborating with medical groups, required
  • In-depth knowledge of pharmacy supply chain management, including pharmacy networks and specialty pharmacy, required
  • Proven background in pharmacy clinical operations, including prior authorization, appeals, grievances
  • Experience with EPIC EHR functionality
  • Proficient in Microsoft Word and Excel
  • Strong commitment to patient confidentiality and thorough knowledge of HIPAA requirements, required