As-Needed Clinical Pharmacist (Remote, Part‑time)

About the role

CalOptima is seeking an As‑Needed Clinical Pharmacist to work remotely on a part‑time basis (16 hours per week). The role supports pharmacy management initiatives, drug utilization review, and clinical quality improvement programs through data analysis, medication reviews, and collaboration with providers.

Key responsibilities

• Generate and analyze claims and utilization reports to identify trends and target utilization management activities.
• Develop, update, and maintain drug utilization criteria and related policies.
• Participate in medication review, disease‑state management, and quality improvement programs such as HEDIS, MTM, and interdisciplinary care teams.
• Prepare drug monographs and utilization reports for the Pharmacy and Therapeutics committee.
• Review prior‑authorization and appeal requests using clinical and regulatory guidelines.
• Collaborate with medical management, data managers, and case managers on data integration and outcomes projects.
• Provide medication profile reviews and evidence‑based recommendations as part of the polypharmacy program.
• Represent the plan at state fair hearings and resolve complaints, grievances, and appeals.

Required profile

• Doctor of Pharmacy (Pharm.D.) degree.
• Current knowledge and expertise in clinical pharmacology and disease states.
• Experience with drug utilization review, prior‑authorization processes, and regulatory compliance.
• Strong analytical abilities to interpret utilization data and generate actionable insights.

Required skills

• Clinical pharmacology knowledge.
• Drug utilization analysis.
• Prior‑authorization review.
• Regulatory compliance.

What we offer

• Competitive salary range $120,881 – $193,410 per year (USD).
• Full telework arrangement.
• Flexible part‑time schedule (16 hours/week) with assignment through September 30 2026.