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Home › Companies › 8b6d34a2 662b 4ceb Abfc 528d20745f96 19000101 000001 › Clinical Advisor

Clinical Advisor

8b6d34a2 662b 4ceb Abfc 528d20745f96 19000101 000001 · Southborough, MA, US, Southborough, MA · Active · $100,000–$110,000 / year · ADP Workforce Now Recruiting

Job facts

FieldValue
Company8b6d34a2 662b 4ceb Abfc 528d20745f96 19000101 000001
TitleClinical Advisor
Normalized title-
Department / team-
LocationSouthborough, MA, United States
Work model-
Employment type-
Salary$100,000–$110,000 / year
Statusactive
ATS providerADP Workforce Now Recruiting
Posted / first seen2025-11-19 / 2026-05-31
Changed / last seen2026-06-18 / 2026-06-18

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Company jobsActive postings from 8b6d34a2 662b 4ceb Abfc 528d20745f96 19000101 000001.Open
Company breakdownsRole, location, ATS, and work model facets for this company.Open
ATS provider jobsActive postings observed through ADP Workforce Now Recruiting.Open
Provider filtered searchThe same provider as a filtered job collection.Open
City jobsActive postings in Southborough.Open
Lifecycle eventsOpen, update, close, and reopen events for this posting.Open
Original postingCanonical source or apply URL captured from the ATS.Open

Linked records

Company8b6d34a2 662b 4ceb Abfc 528d20745f96 19000101 000001
Sourcee0ea2e22-8f53-4793-ba61-fd2c0e7555a2
ATS providerADP Workforce Now Recruiting

Description

Job Posting Title Clinical Advisor Job Description Company Overview: Join us in our mission to transform healthcare! nirvanaHealth (under RxAdvance Corp.) is committed to bringing the art of the possible to the payer and PBM industries. We invest in our employees at every stage of life. Success radiates across all levels of our organization, driven by competitive benefits and a strong focus on employee wellness, we aim to support all aspects of employee growth. Characterized by curiosity, innovation, and an entrepreneurial mindset, nirvanaHealth is the first to offer medical and pharmacy benefit management solutions that run on the same platform, made possible by our creation, Aria – the first robotic process automation cloud platform designed for healthcare. Under the leadership of our Chairman John Sculley, former Apple CEO, and our President & CEO Ravi Ika, nirvanaHealth endeavors to sizably reduce the $1 trillion in waste in healthcare administrative and medical costs. We are seeking self-determined players to join our team – folks who embrace the grind and hustle of a growing company, are collaborative and innovative, are life-long learners and growers, and have an entrepreneurial and positive mindset. Job Summary: The Clinical Advisor is responsible for utilizing pharmacy acumen, medication expertise, and healthcare payer knowledge related to drug-related prior authorization requirements and medication guidelines to support PA operations (in completing PA reviews), PA technology and automation, consultation on evidence-based guidelines and pharmacy policy, reporting and analytics, and quality management programs. The Clinical Advisor will collaborate with a team of pharmacy technicians and pharmacists in Pharmacy Operations Job Responsibilities (but not limited to): Serves as a subject matter expert in the development and maintenance of drug formularies and clinical programs. Works with stakeholders to understand client’s product-specific requirements and configuration needs and translate them into technical design specifications and data flow for development, coding, and configuration. Coordinates activities as part of the Formulary Development and Maintenance team and recommends measures to improve performance and efficiency. Manage operations of the Pharmacy & Therapeutics (P&T) Committee including scheduling drug class reviews, reviewing new branded agents, coordinating internal/external membership, documenting P&T minutes, and preparing and organizing P&T files. Conducts and evaluates research necessary for the development of utilization management strategies. Performs clinical reviews of PA, Step Therapy, Quantity Limit, and all other pharmacy utilization requests in accordance with quality, timeliness, and efficiency standards. Performs coverage determinations and appeals requests according to criteria guidelines and in compliance with all state and federal regulations, including Medicare and Medicaid Takes calls from internal and external stakeholders as it pertains to the PA process, answering in a timely, accurate and professional manner. Develops and implements clinical utilization criteria for new market entries and market updates utilizing evidence-based medicine principles. Makes strategic recommendations including benefit design and formulary analysis, provision of clinical drug information, Pharmacy & Therapeutics support and participation, rational drug formulary positioning, online system edits and restrictions, ongoing clinical product evaluations, and client pharmacy benefit utilization and performance trends as required. Assists with compiling statistical data, reporting and analyses to demonstrate PA clinical, financial, and operational effectiveness and quality. Supports Fraud, Waste and Abuse (FWA) program system oversight and communicates any suspected fraud discovered. Education and/or Training: Bachelor’s degree in pharmacy or related fields required.\ Doctor of Pharmacy (PharmD) degree from an ACPE accredited college is preferred. Managed Care or Clinical Residency program residency highly preferred. Professional Experience: At least 1 year of recent managed care experience in a PBM or health plan setting is preferred. Experience with Medicare Part D highly preferred. Expert knowledge of the principles and practices of pharmaceutical science, a working knowledge of managed care and policy development as well as working knowledge of state and federal controlled substances and related laws, rules, and regulations. Experience using clinical resources, e.g., Micromedex, Lexicomp, Clinical Pharmacology. Licenses/Certifications: Registered and in good standing with the Board of Registration in Pharmacy. Active, non-restricted pharmacist license.

Full job record

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Source IDe0ea2e22-8f53-4793-ba61-fd2c0e7555a2
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TitleClinical Advisor
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Activeyes
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Department—
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Employment Type—
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CountryUnited States
RegionMA
CitySouthborough
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Salary Min100,000
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First Seen At2026-05-31 18:58:06Z
Last Seen At2026-06-18 13:22:52Z
Last Checked At2026-06-18 13:22:52Z
Last Changed At2026-06-18 13:22:52Z
Inactive At—
Source Posted At2025-11-19 16:58:00Z
Source Updated At—
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Extensions
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--tw-shadow: 0 0 #0000; --tw-ring-inset: ; --tw-ring-offset-width: 0px; --tw-ring-offset-color: #fff; --tw-ring-color: rgba(59,130,246,.5); --tw-ring-offset-shadow: 0 0 #0000; --tw-ring-shadow: 0 0 #0000; overflow-wrap: break-word;\"><p style='box-sizing: border-box; --tw-shadow: 0 0 #0000; --tw-ring-inset: ; --tw-ring-offset-width: 0px; --tw-ring-offset-color: #fff; --tw-ring-color: rgba(59,130,246,.5); --tw-ring-offset-shadow: 0 0 #0000; --tw-ring-shadow: 0 0 #0000; margin-top: 0px; margin-bottom: 15px; line-height: 1.25; color: rgb(0, 0, 0); font-family: Circular, -apple-system, BlinkMacSystemFont, \"Segoe UI\", Roboto, Oxygen, Ubuntu, Cantarell, \"Fira Sans\", \"Droid Sans\", \"Helvetica Neue\", sans-serif; font-size: 16px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; background-color: rgb(255, 255, 255);'><strong style=\"box-sizing: border-box; --tw-shadow: 0 0 #0000; --tw-ring-inset: ; --tw-ring-offset-width: 0px; --tw-ring-offset-color: #fff; --tw-ring-color: rgba(59,130,246,.5); --tw-ring-offset-shadow: 0 0 #0000; --tw-ring-shadow: 0 0 #0000; font-weight: 700;\"><span style=\"box-sizing: border-box; --tw-shadow: 0 0 #0000; --tw-ring-inset: ; --tw-ring-offset-width: 0px; --tw-ring-offset-color: #fff; --tw-ring-color: rgba(59,130,246,.5); --tw-ring-offset-shadow: 0 0 #0000; --tw-ring-shadow: 0 0 #0000; color: rgb(0, 0, 0); font-size: 14px; font-family: arial, sans-serif;\">Company Overview:</span></strong><span style=\"box-sizing: border-box; --tw-shadow: 0 0 #0000; --tw-ring-inset: ; --tw-ring-offset-width: 0px; --tw-ring-offset-color: #fff; --tw-ring-color: rgba(59,130,246,.5); --tw-ring-offset-shadow: 0 0 #0000; --tw-ring-shadow: 0 0 #0000; color: rgb(0, 0, 0); font-size: 14px; font-family: arial, sans-serif;\">&nbsp;</span></p><p data-pasted=\"true\" style='box-sizing: border-box; --tw-shadow: 0 0 #0000; --tw-ring-inset: ; --tw-ring-offset-width: 0px; --tw-ring-offset-color: #fff; --tw-ring-color: rgba(59,130,246,.5); --tw-ring-offset-shadow: 0 0 #0000; --tw-ring-shadow: 0 0 #0000; margin-top: 0px; margin-bottom: 1rem; line-height: 1.25; color: rgb(38, 35, 33); font-family: Circular, -apple-system, BlinkMacSystemFont, \"Segoe UI\", Roboto, Oxygen, Ubuntu, Cantarell, \"Fira Sans\", \"Droid Sans\", \"Helvetica Neue\", sans-serif; font-size: 16px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: rgb(255, 255, 255); text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;'>Join us in our mission to transform healthcare! nirvanaHealth (under RxAdvance Corp.) is committed to bringing the art of the possible to the payer and PBM industries. We invest in our employees at every stage of life. Success radiates across all levels of our organization, driven by competitive benefits and a strong focus on employee wellness, we aim to support all aspects of employee growth. &nbsp;</p><p style='box-sizing: border-box; --tw-shadow: 0 0 #0000; --tw-ring-inset: ; --tw-ring-offset-width: 0px; --tw-ring-offset-color: #fff; --tw-ring-color: rgba(59,130,246,.5); --tw-ring-offset-shadow: 0 0 #0000; --tw-ring-shadow: 0 0 #0000; margin-top: 0px; margin-bottom: 1rem; line-height: 1.25; color: rgb(38, 35, 33); font-family: Circular, -apple-system, BlinkMacSystemFont, \"Segoe UI\", Roboto, Oxygen, Ubuntu, Cantarell, \"Fira Sans\", \"Droid Sans\", \"Helvetica Neue\", sans-serif; font-size: 16px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: rgb(255, 255, 255); text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;'>Characterized by curiosity, innovation, and an entrepreneurial mindset, nirvanaHealth is the first to offer medical and pharmacy benefit management solutions that run on the same platform, made possible by our creation, Aria &ndash; the first robotic process automation cloud platform designed for healthcare. &nbsp;</p><p style='box-sizing: border-box; --tw-shadow: 0 0 #0000; --tw-ring-inset: ; --tw-ring-offset-width: 0px; --tw-ring-offset-color: #fff; --tw-ring-color: rgba(59,130,246,.5); --tw-ring-offset-shadow: 0 0 #0000; --tw-ring-shadow: 0 0 #0000; margin-top: 0px; margin-bottom: 1rem; line-height: 1.25; color: rgb(38, 35, 33); font-family: Circular, -apple-system, BlinkMacSystemFont, \"Segoe UI\", Roboto, Oxygen, Ubuntu, Cantarell, \"Fira Sans\", \"Droid Sans\", \"Helvetica Neue\", sans-serif; font-size: 16px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: rgb(255, 255, 255); text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;'>Under the leadership of our Chairman John Sculley, former Apple CEO, and our President &amp; CEO Ravi Ika, nirvanaHealth endeavors to sizably reduce the $1 trillion in waste in healthcare administrative and medical costs. We are seeking self-determined players to join our team &ndash; folks who embrace the grind and hustle of a growing company, are collaborative and innovative, are life-long learners and growers, and have an entrepreneurial and positive mindset.</p><p style=\"box-sizing: border-box; --tw-shadow: 0 0 #0000; --tw-ring-inset: ; --tw-ring-offset-width: 0px; --tw-ring-offset-color: #fff; --tw-ring-color: rgba(59,130,246,.5); --tw-ring-offset-shadow: 0 0 #0000; --tw-ring-shadow: 0 0 #0000; margin-top: 0px; margin-bottom: 1rem; line-height: 1.25;\"><span style=\"box-sizing: border-box; --tw-shadow: 0 0 #0000; --tw-ring-inset: ; --tw-ring-offset-width: 0px; --tw-ring-offset-color: #fff; --tw-ring-color: rgba(59,130,246,.5); --tw-ring-offset-shadow: 0 0 #0000; --tw-ring-shadow: 0 0 #0000; color: rgb(0, 0, 0); font-size: 14px; font-family: arial, sans-serif;\"><strong style=\"box-sizing: border-box; --tw-shadow: 0 0 #0000; --tw-ring-inset: ; --tw-ring-offset-width: 0px; --tw-ring-offset-color: #fff; --tw-ring-color: rgba(59,130,246,.5); --tw-ring-offset-shadow: 0 0 #0000; --tw-ring-shadow: 0 0 #0000; font-weight: 700;\">Job Summary:</strong></span></p><p style=\"box-sizing: border-box; --tw-shadow: 0 0 #0000; --tw-ring-inset: ; --tw-ring-offset-width: 0px; --tw-ring-offset-color: #fff; --tw-ring-color: rgba(59,130,246,.5); --tw-ring-offset-shadow: 0 0 #0000; --tw-ring-shadow: 0 0 #0000; margin-top: 0px; margin-bottom: 1rem; line-height: 1.25;\">The Clinical Advisor is responsible for utilizing pharmacy acumen, medication expertise, and healthcare payer knowledge related to drug-related prior authorization requirements and medication guidelines to support PA operations (in completing PA reviews), PA technology and automation, consultation on evidence-based guidelines and pharmacy policy, reporting and analytics, and quality management programs. The Clinical Advisor will collaborate with a team of pharmacy technicians and pharmacists in Pharmacy Operations</p><p style=\"box-sizing: border-box; --tw-shadow: 0 0 #0000; --tw-ring-inset: ; --tw-ring-offset-width: 0px; --tw-ring-offset-color: #fff; --tw-ring-color: rgba(59,130,246,.5); --tw-ring-offset-shadow: 0 0 #0000; --tw-ring-shadow: 0 0 #0000; margin-top: 0px; margin-bottom: 1rem; line-height: 1.25;\"><span style=\"box-sizing: border-box; --tw-shadow: 0 0 #0000; --tw-ring-inset: ; --tw-ring-offset-width: 0px; --tw-ring-offset-color: #fff; --tw-ring-color: rgba(59,130,246,.5); --tw-ring-offset-shadow: 0 0 #0000; --tw-ring-shadow: 0 0 #0000; color: rgb(0, 0, 0); font-size: 14px; font-family: arial, sans-serif;\"><strong style=\"box-sizing: border-box; --tw-shadow: 0 0 #0000; --tw-ring-inset: ; --tw-ring-offset-width: 0px; --tw-ring-offset-color: #fff; --tw-ring-color: rgba(59,130,246,.5); --tw-ring-offset-shadow: 0 0 #0000; --tw-ring-shadow: 0 0 #0000; font-weight: 700;\">Job Responsibilities (but not limited to):</strong></span></p><ul style=\"box-sizing: border-box; --tw-shadow: 0 0 #0000; --tw-ring-inset: ; --tw-ring-offset-width: 0px; --tw-ring-offset-color: #fff; --tw-ring-color: rgba(59,130,246,.5); --tw-ring-offset-shadow: 0 0 #0000; --tw-ring-shadow: 0 0 #0000;\"><li>Serves as a subject matter expert in the development and maintenance of drug formularies and clinical programs.</li><li>Works with stakeholders to understand client&rsquo;s product-specific requirements and configuration needs and translate them into technical design specifications and data flow for development, coding, and configuration.</li><li>Coordinates activities as part of the Formulary Development and Maintenance team and recommends measures to improve performance and efficiency.</li><li>Manage operations of the Pharmacy &amp; Therapeutics (P&amp;T) Committee including scheduling drug class reviews, reviewing new branded agents, coordinating internal/external membership, documenting P&amp;T minutes, and preparing and organizing P&amp;T files.</li><li>Conducts and evaluates research necessary for the development of utilization management strategies.</li><li>Performs clinical reviews of PA, Step Therapy, Quantity Limit, and all other pharmacy utilization requests in accordance with quality, timeliness, and efficiency standards.</li><li>Performs coverage determinations and appeals requests according to criteria guidelines and in compliance with all state and federal regulations, including Medicare and Medicaid</li><li>Takes calls from internal and external stakeholders as it pertains to the PA process, answering in a timely, accurate and professional manner.</li><li>Develops and implements clinical utilization criteria for new market entries and market updates utilizing evidence-based medicine principles.</li><li>Makes strategic recommendations including benefit design and formulary analysis, provision of clinical drug information, Pharmacy &amp; Therapeutics support and participation, rational drug formulary positioning, online system edits and restrictions, ongoing clinical product evaluations, and client pharmacy benefit utilization and performance trends as required.</li><li>Assists with compiling statistical data, reporting and analyses to demonstrate PA clinical, financial, and operational effectiveness and quality.</li><li>Supports Fraud, Waste and Abuse (FWA) program system oversight and communicates any suspected fraud discovered.</li></ul><p style=\"box-sizing: border-box; --tw-shadow: 0 0 #0000; --tw-ring-inset: ; --tw-ring-offset-width: 0px; --tw-ring-offset-color: #fff; --tw-ring-color: rgba(59,130,246,.5); --tw-ring-offset-shadow: 0 0 #0000; --tw-ring-shadow: 0 0 #0000; margin-top: 0px; margin-bottom: 1rem; line-height: 1.25;\"><span style=\"box-sizing: border-box; --tw-shadow: 0 0 #0000; --tw-ring-inset: ; --tw-ring-offset-width: 0px; --tw-ring-offset-color: #fff; --tw-ring-color: rgba(59,130,246,.5); --tw-ring-offset-shadow: 0 0 #0000; --tw-ring-shadow: 0 0 #0000; color: rgb(0, 0, 0); font-size: 14px; font-family: arial, sans-serif;\">Education and/or Training:</span></p><ul style=\"box-sizing: border-box; --tw-shadow: 0 0 #0000; --tw-ring-inset: ; --tw-ring-offset-width: 0px; --tw-ring-offset-color: #fff; --tw-ring-color: rgba(59,130,246,.5); --tw-ring-offset-shadow: 0 0 #0000; --tw-ring-shadow: 0 0 #0000;\"><li>Bachelor&rsquo;s degree in pharmacy or related fields required.\\</li><li>Doctor of Pharmacy (PharmD) degree from an ACPE accredited college is preferred.</li><li>Managed Care or Clinical Residency program residency highly preferred.</li></ul><p data-pasted=\"true\">Professional Experience:</p><ul><li>At least 1 year of recent managed care experience in a PBM or health plan setting is preferred.</li><li>Experience with Medicare Part D highly preferred.</li><li>Expert knowledge of the principles and practices of pharmaceutical science, a working knowledge of managed care and policy development as well as working knowledge of state and federal controlled substances and related laws, rules, and regulations.</li><li>Experience using clinical resources, e.g., Micromedex, Lexicomp, Clinical Pharmacology.</li></ul><p>Licenses/Certifications:</p><ul><li>Registered and in good standing with the Board of Registration in Pharmacy.</li><li>Active, non-restricted pharmacist license.</li></ul></div></div></div></div></div></div></div></div></div>\n",
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