Clinical Pharmacist - SCAN Temp

Founded in 1977 as the Senior Care Action Network, SCAN began with a simple but radical idea: that older adults deserve to stay healthy and independent. That belief was championed by a group of community activists we still honor today as the "12 Angry Seniors." Their mission continues to guide everything we do.

Today, SCAN is a nonprofit health organization serving more than 500,000 people across Arizona, California, Nevada, New Mexico, Texas, and Washington, with over $8 billion in annual revenue. With nearly five decades of experience, we have built a distinctive, values-driven platform dedicated to improving care for older adults.

Our work spans Medicare Advantage, fully integrated care models, primary care, care for the most medically and socially complex populations, and next-generation care delivery models. Across all of this, we are united by a shared commitment: combining compassion with discipline, innovation with stewardship, and growth with integrity.

At SCAN, we believe scale should strengthen-not dilute-our mission. We are building the future of care for older adults, grounded in purpose, accountability, and respect for the people and communities we serve.

The Job

The Clinical Pharmacist - SCAN Temp will play an instrumental role in ensuring compliance and clinical appropriateness of Part D coverage determinations, appeals and grievances, and Part C organizational determinations for a senior-focused Medicare Advantage Plan. The Clinical Pharmacist will work alongside the Director to execute and ensure CMS compliant operations and strong star rating performance for these areas. In addition, the Clinical Pharmacist will support Interdisciplinary Care Team work, and complete medication-related clinical reviews to support the care management teams at SCAN. The Clinical Pharmacist will participate in other managed care responsibilities as assigned. This position reports into the Manager, Pharmacy Experience & Access.

You Will

• Serve as a subject matter expert of Part D coverage determinations, redeterminations, and applicable Part C organizational determinations.

• Utilize Medicare Part D knowledge and expertise to ensure compliance and clinical appropriateness with coverage determinations, appeals, and grievances.

• Maintain current knowledge of relevant Medicare Part D regulations by participating in CMS calls and reading released guidance and implementing changes/updates to maintain compliance.

• Produce and maintain Prior Authorization criteria and Step Therapy criteria in accordance with CMS requirements on monthly and annual basis Maintain professional and technical knowledge by attending educational workshops. Develop and maintain formulary exception criteria.

• With direction from the Manager, develop, coordinate and implement an effective on-going strategy to achieve strong star ratings and audit readiness for assigned functions.

• Serve as the clinical appropriateness subject matter expert during regulatory audits.

• Ensure rigorous daily monitoring of operations for compliance performance 8 Contribute in quality improvement and process enhancement projects internally and with contracted PBM.

• Foster strong relations with internal departments and contracted PBM.

• Serve as pharmacy expert on Interdisciplinary Care Team, other committees, and workgroups as required.

• Support the care management teams by reviewing records of patients to determine the appropriateness of medication therapy, consulting on dosages, and collaborating with healthcare professionals to ensure optimal patient care. Serve a clinical bridge to the Formulary & Benefits team on effectiveness and considerations for additional formulary utilization management strategies

• We seek Rebels who are curious about AI and its power to transform how we operate and serve our members.

• Actively support the achievement of SCAN's Vision and Goals.

• Other duties as assigned.

Your Qualifications

• 3-5 years of related experience .Performs work under minimal supervision

• Bachelor's Degree or equivalent experience.

• Handles complex issues and problems, and refers only the most complex issues to higher-level staff.

• Possesses comprehensive knowledge of subject matter .Provides leadership, coaching, and/or mentoring to a subordinate group.

• Ability to work as part of a team.

• Ability to foster teamwork.

• Decision-making skills.

• Strong oral and written communication skills.

• Ability to build collaborative relationships.

• Customer/client orientation.

• Detail oriented.

• Required technical skills: Microsoft Office (Word, Excel, PowerPoint, Outlook, Teams), Visio.

What's in it for you?

• This is a temporary opportunity for a limited period of time

• Base Pay Range: $106,200 to $153,705 per year

• Work Mode: Hybrid (requires onsite presence twice per week)

• Medical Benefits

• Paid Sick Time

• Excellent 401(k) Retirement Saving Plan

• Robust employee recognition program

• An opportunity to become part of a team that makes a difference to our members and our community every day!

We're always looking for talented people to join our team! Qualified applicants are encouraged to apply now!

At SCAN we believe that it is our business to improve the state of our world. Each of us has a responsibility to drive Equality in our communities and workplaces. We are committed to creating a workforce that reflects our community through inclusive programs and initiatives such as equal pay, employee resource groups, inclusive benefits, and more.

SCAN is proud to be an Equal Employment Opportunity and Affirmative Action workplace. Individuals seeking employment will receive consideration for employment without regard to race, color, national origin, religion, age, sex (including pregnancy, childbirth or related medical conditions), sexual orientation, gender perception or identity, age, marital status, disability, protected veteran status or any other status protected by law. A background check is required.

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Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities

The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information. 41 CFR 60-1.35(c)