Medicare Advantage Staff Pharmacist

General Information

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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

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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

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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