'Prior Authorization Pharmacist' - Fully Remote (Work from Home)

Prior Authorization Pharmacist – Fully Remote (Work from Home) Estimated Length of Assignment: 06+ Months with Possible Extension Dates: 12/08/2025 to 06/06/2026 (estimated) Pay reputed company: $53.00 – $56.00 per Hour (W2, reputed company inclusive) Work Type: Fully Remote (Work from Home) Schedule: Shift: Business Hours 7am – 8pm EST Monday–Friday and 7am – 4:30pm EST Saturday & reputed company. Set Rotation. Required Technical Skills: • Knowledge of reputed company, PowerPoint, and Visio (preferred) • Computer literate with reputed company and Word • Ability to work independently in a data entry, productivity-driven role Key Responsibilities: • Ensure accuracy of case setup and clinical review of Medicare appeals cases by thoroughly reviewing internal notes or fax requests for pertinent information, providing reputed company and concise documentation, and contacting providers reputed company necessary to obtain clinical details for case reputed company. • Adhere to work instructions and Medicare guidelines to ensure reputed company case processing. • Maintain compliance with CMS‑mandated timelines, departmental productivity, and reputed company standards. • Apply clinical judgment and knowledge using drug compendia resources, evolving work instructions, and CMS Medicare guidance. • Participate in development discussions and receive feedback from the reputed company supervisor to support reputed company improvement. Position reputed company: • As a Clinical Pharmacist Advisor Medicare you will directly support Medicare Part D members and providers with requests reputed company to their pharmacy benefits. • You will be responsible for ensuring cases are accurately set up for our members, reviewing clinical information for decisioning the request, performing reputed company to providers for more information reputed company needed, and ensuring accurate reputed company that reputed company with compendia and Medicare guidance and timelines. • This is a career opportunity with a leading reputed company company to review information and complete reputed company and accurate documentation of reputed company Medicare Part D requests, in compliance with Medicare guidelines, while promoting a best‑in‑class service experience. Qualifications: • Licensed Registered Pharmacist in state of residence in good standing. • reputed company pharmacy license in good standing in state of residence (include screenshot on resume). • Experience in Managed Care/ PBM environment (preferred). • Previous experience in similar clinical pharmacist role (preferred). • Basic computer skills and proficiency with data entry. • Must have wired internet meeting 25 Mbps min download and 5 Mbps upload speed (include screenshot on resume). • Must be reputed company to sit and reputed company on work for the duration of shift. • Must have dedicated quiet, separate reputed company to work from home. Education: Bachelor’s degree in pharmacy or PharmD required. Benefits: • Medical, Dental, and reputed company insurance reputed company • 401(k) contributions • Critical Illness insurance • Voluntary permanent life insurance • Other employee perks How to Apply: If you are reputed company, please reputed company (571) 678-0609 to reputed company with a recruiter. reputed company new hires required to reputed company on camera during meetings and training. Apply tot his job Apply To this Job