New

Clinical Pharmacist - Medicare

Central California Alliance for Health
$130,168-$208,270
paid time off, paid holidays, retirement plan
United States, California, Santa Cruz
Aug 28, 2025
We have an opportunity to join the Alliance as Clinical Pharmacist - Medicare in the Pharmacy Department. Our mission is to improve member health outcomes and quality of pharmacy services by enhancing care coordination, medication management, and medication adherence in collaboration with our internal teams and community partners. We handle pharmacy authorizations, Alliance formulary, pharmacy utilization and projects. WHAT YOU'LL NEED TO BE SUCCESSFUL To read the full position description, and list of requirementsclick here. Knowledge of: Medicare Part D and formulary management, and medication therapy management (MTM) services Computerized drug programs Drug utilization review Drugs and supplies required in the operation of a pharmacy Drug formularies and drug billings Ability to: Interpret and apply complex principles, policies, terms and procedures Identify issues and potential risks, conduct research, gather and analyze information, reach logical and sound conclusions, and make recommendations for action Work independently and make decisions related to areas of functional responsibility Analyze data and prepare written, statistical, and oral reports Education and Experience Current active and unrestricted license as a Pharmacist issued by the state of California Doctor of Pharmacy Doctorate of Pharmacy (Pharm. D.) degree and three years of experience as a practicing pharmacist in a health plan, hospital, pharmacy, and/or retail pharmacy, which included experience with drug utilization review, prior authorization activities, formularies, and drug billings and a minimum of two years of experience working with Medicare Part D regulations (one year of experience in a managed care environment or clinical residency may substitute for the three years of experience); or an equivalent be qualifying combination of education and experience may OTHER INFORMATION We are in a hybrid work environment and we anticipate that the interview process will take place remotely via Microsoft Teams. While some staff may work full telecommuting schedules, attendance at quarterly company-wide events or department meetings will be expected. In-office or in-community presence may be required for some positions and is dependent on business need. Details about this can be reviewed during the interview process. The full compensation range for this position is listed by location below. The actual compensation for this role will be determined by our compensation philosophy, analysis of the selected candidate's qualifications (direct or transferrable experience related to the position, education or training), as well as other factors (internal equity, market factors, and geographic location). Typical areas in Zone 1: Bay Area, Sacramento, Los Angeles area, San Diego area Typical areas in Zone 2: Fresno area, Bakersfield, Central Valley (with the exception of Sacramento), Eastern California, Eureka area Santa Cruz County Pay Range $130,168 — $208,270 USD Merced County Pay Range $118,454 — $189,530 USD Monterey County Pay Range $130,168 — $208,270 USD Mariposa County Pay Range $118,454 — $189,530 USD San Benito County Pay Range $130,168 — $208,270 USD OUR BENEFITS Available for all regular Alliance employees working more than 30 hours per week.Some benefits are available on a pro-rated basis for part-time employees. These benefits are unavailable to temporary employees while on an assignment with the Alliance. Medical, Dental and Vision Plans Ample Paid Time Off 12 Paid Holidays per year 401(a) Retirement Plan 457 Deferred Compensation Plan Robust Health and Wellness Program Onsite EV Charging Stations ABOUT US We are a group of over 500 dedicated employees, committed to our mission of providing accessible, quality health care that is guided by local innovation. We feel that our work is bigger than ourselves. We leave work each day knowing that we made a difference in the community around us. Join us at Central California Alliance for Health (the Alliance), where you will be part of a culture that is respectful, diverse, professional and fun, and where you are empowered to do your best work. As a regional non-profit health plan, we serve members in Mariposa, Merced, Monterey, San Benito and Santa Cruz counties. To learn more about us, take a look at ourFact Sheet. The Alliance is an equal employment opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), sexual orientation, gender perception or identity, national origin, age, marital status, protected veteran status, or disability status. We are an E-Verify participating employer At this time the Alliance does not provide any type of sponsorship. Applicants must be currently authorized to work in the United States on a full-time, ongoing basis without current or future needs for any type of employer supported or provided sponsorship.