Clinical Pharmacist
vor 2 Wochen
Mercor, on behalf of an AI Lab, is seeking a Clinical Pharmacist experienced in Prior Authorization (PA) and Specialty Pharmacy workflows to contribute to data-driven healthcare innovation. In this role, you'll bridge healthcare operations and artificial intelligence — helping us train and refine AI models that streamline pharmacy workflows, improve clinical accuracy in prescription handling, and enhance patient outcomes. You'll collaborate with pharmacy technicians, pharmacists, data specialists, and engineers to make sure our systems understand the complexities of specialty pharmacy — from verifying benefits to interpreting medical necessity criteria and payer requirements.
What You'll Do
- Annotate and structure healthcare data: Curate, label, and clinically validate pharmacy workflows, PA criteria, and medical documentation for use in AI model training.
- Collaborate with AI engineers: Provide real-world clinical insights that guide model design, decision logic, and validation using authentic specialty scenarios.
- Quality assurance: Perform clinical review of AI-generated outputs for accuracy, safety, and compliance with payer policies and pharmacy standards; define guardrails for high-risk therapies (e.g., REMS, dose limits, step therapy).
- Knowledge sharing: Help define clinical data schemas, SOPs, and evaluation metrics that reflect authentic pharmacy operations; mentor pharmacy technicians and reviewers.
- What We're Looking For
Experience:
- PharmD (or BS Pharm) and active pharmacist license in good standing
- 3+ years as a Clinical Pharmacist in a Specialty Pharmacy, health system, or PBM/managed care setting
- Demonstrated experience with Prior Authorizations, coverage determinations, appeals, and benefits investigations
Knowledge:
- Fluency with payer systems, medical necessity criteria, step therapy, quantity limits, and formulary management
- Familiarity with specialty drugs and REMS programs across oncology, immunology, neurology, and other therapeutic areas
- Understanding of HIPAA compliance, PHI handling, and documentation standards
Skills:
- Strong clinical judgment, attention to detail, and documentation
- Comfort with structured data tools (Excel, EHR/EMR systems, CRMs)
- Ability to translate policies and guidelines into precise decision logic and annotation instructions
- Cross-functional communication with engineers, data scientists, and operations teams
Preferred:
- Board certification (e.g., BCPS, BCOP, BCACP) or equivalent specialty experience
- Experience collaborating with data or engineering teams; prior exposure to AI/ML evaluation or labeling tools
- Familiarity with Medicare/Medicaid and major commercial payer portals and policies
Why Join Us
- Be part of a mission-driven effort to modernize pharmacy operations through AI
- Work at the intersection of clinical expertise and data intelligence
- Collaborate with engineers and data scientists shaping next-gen healthcare systems
- Competitive compensation, flexible remote work, and growth opportunities in a rapidly expanding domain
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