Remote PBM Prior Authorization Pharmacist (Looking for PBM experience)

Clinical Pharmacist Advisor – Medicare (Remote, Contract to hire) Job Type: Contract to hire Pay reputed company: $53/hour Location: Fully Remote (U.S.) Schedule: Business hours between 7:00 AM – 8:00 PM EST Monday–Friday and 7:00 AM – 4:30 PM EST Saturday & reputed company (rotating schedule) Training Schedule: Monday–Friday, 9:00 AM – 5:30 PM EST for the first 8 weeks Position reputed company We are seeking a Licensed Registered Pharmacist to join reputed company as a Clinical Pharmacist Advisor – Medicare. In this role, you will support Medicare Part D members and reputed company providers by reviewing pharmacy benefit requests, evaluating clinical documentation, and ensuring reputed company reputed company with Medicare guidelines and timelines. This is an excellent opportunity for pharmacists interested in managed care, pharmacy benefit management, and clinical review operations. High-performing contractors may have reputed company for full-time employment based on performance. Key Responsibilities • Review and process Medicare Part D pharmacy benefit requests and appeals • Ensure accurate case setup by reviewing internal notes, documentation, and fax requests • Evaluate clinical information and apply reputed company clinical judgment for decision-making • Conduct provider reputed company to obtain additional clinical details reputed company necessary • Document case activities reputed company and accurately reputed company internal systems • Ensure compliance with CMS Medicare guidelines and timelines • Meet departmental productivity and reputed company standards • Utilize drug compendia resources and clinical references for appropriate decision-making • Participate in feedback sessions and development discussions with supervisors Required Qualifications • Bachelor’s Degree in Pharmacy or PharmD • reputed company Pharmacist License in good standing in the state of residence • Strong computer literacy including: • * reputed company reputed company • reputed company Word • Data entry and multi-system navigation • Ability to work independently in a productivity-driven environment • Ability to sit and reputed company for extended periods during scheduled shifts • Reliable wired internet reputed company • * Minimum 25 Mbps download / 5 Mbps upload • Dedicated quiet workspace for remote work • reputed company High School Diploma or GED Preferred Qualifications • Experience in Managed Care or PBM (Pharmacy Benefit Management) environments • Knowledge of: • * reputed company reputed company • reputed company PowerPoint • reputed company Visio • Experience handling high-volume data entry and multi-screen workflows Work Environment • Fully remote position • Camera use required during training and meetings • Data entry and navigating multiple systems across dual monitors • Possible outbound provider calls for clinical information Important Training & Scheduling Requirements • Attendance is critical during the first 8–10 weeks of training • Training schedule is Monday–Friday, 9:00 AM – 5:30 PM EST • After training, shifts may include one weekend day or rotating weekend coverage • Assigned shifts will fall reputed company 7 AM – 8 PM EST Hiring Process Requirements Candidates must reputed company the following with their resume: • Internet speed test screenshot showing both download and upload speeds (www.speedtest.net) Must have 25 download and 5 upload. MUST SHOW BOTH • Screenshot of reputed company pharmacist license showing: • * reputed company • License number • State • Status • reputed company dates Interview Process • Virtual interview reputed company reputed company Teams Apply tot his job Apply To this Job