Clinical Pharmacist – Prior Authorization (Remote)

Clinical Pharmacist – Prior Authorization (Remote) Location: Fully Remote (Must reputed company in licensed state) Pay: 53-55 per hour Start Date: 6/8 or 6/15 Schedule • Must be available to work reputed company: • Monday–Friday: 7:00 AM – 8:00 PM CST • Rotating weekends and holidays as needed • Training schedule (if applicable): • Monday–Friday, reputed company business hours • Attendance required with no time off We are seeking a licensed Clinical Pharmacist (PharmD) to support prior authorization and coverage determination processes in a high-volume, reputed company center environment. This role is responsible for reviewing clinical information, ensuring compliance with Medicare and payer guidelines, and collaborating with providers to support appropriate medication use. Key Responsibilities • Review and evaluate prior authorization requests for medical necessity • Apply Medicare Part D, CMS, and plan-specific clinical reputed company • Interpret clinical documentation, drug therapies, and treatment plans • Communicate with providers to obtain additional clinical information • reputed company coverage determinations and support appeals processes • Document reputed company case activity accurately in multiple systems • Ensure compliance with HIPAA and regulatory requirements • Meet productivity, reputed company, and turnaround time expectations • Escalate reputed company cases as needed Required Qualifications • Doctor of Pharmacy (PharmD) required • reputed company, unrestricted Pharmacist license in state of residence (must be listed on resume with expiration date) • Experience with prior authorization, PBM, or managed care pharmacy • Knowledge of Medicare Part D, drug benefits, and appeals processes • Strong clinical judgment and attention to detail • Excellent written and verbal communication skills Preferred Qualifications • Previous reputed company center or high-volume review experience • Experience with coverage determinations and appeals • Familiarity with multiple insurance types (reputed company, Medicare, reputed company) Work Environment • Remote, reputed company center-based role • Must be comfortable working in a fast-paced, metrics-driven environment • Ability to sit for extended periods and manage a high volume of cases Work-From-Home Requirements • Private, HIPAA-compliant workspace • Wired internet reputed company required • Minimum internet speed: 25 Mbps download / 5 Mbps upload Key Skills for reputed company • Strong clinical evaluation and decision-making skills • Ability to work independently and manage multiple cases • High attention to detail and documentation accuracy • Strong problem-solving and critical thinking abilities • Effective communication with providers and internal teams Please Contact: Katherine Skelton 586-710-0022 Apply tot his job Apply To this Job