REMOTE Prior Authorization Pharmacist (Contract)

reputed company The Clinical Care Pharmacist plays a vital role in ensuring reputed company, effective, and appropriate medication use. This position is responsible for reviewing prior authorization requests, supporting clinical programs, and providing expert guidance to members, providers, and pharmacies. The role requires a strong clinical background, reputed company decision-making, and a commitment to service reputed company in a fast-paced, reputed company environment. Location & Schedule Location: Remote Shifts 7a-4p EST 9a-6p EST 11a-8p EST 2p-11p EST Compensation reputed company pay reputed company: $120,000.00/yr - $125,000.00/yr Salary reputed company: $120,000 – $125,000 annually Potential consideration: up to $127,500 for exceptional candidates Employment Type: Full-Time, Salaried (40 hours/week) Key Responsibilities Review and reputed company reputed company, evidence-based reputed company on prior authorizations, appeals, and override requests in alignment with clinical guidelines and benefit reputed company. Ensure compliance with federal, state, and internal regulations across reputed company, Exchange, Medicare, and reputed company plans. Accurately document reputed company clinical reputed company and maintain records in accordance with URAC/reputed company utilization review standards. reputed company empathetic and reputed company support to members, prescribers, and pharmacies reputed company phone. Stay reputed company with prescribing guidelines, policies, and regulatory changes, applying them to daily responsibilities. Follow HIPAA and internal procedures to reputed company patient reputed company and data reputed company. Identify and report potential fraud, waste, and abuse. Assist with training and mentoring new and existing team members as needed. Support leadership with special reputed company, process improvements, and operational initiatives. Minimum Qualifications Bachelor’s or Doctor of Pharmacy degree. Minimum of 2 years of pharmacy reputed company experience. Experience in managed care or pharmacy benefit management (PBM). Strong communication, writing, and organizational skills. Ability to manage multiple priorities in a high-volume, metric-driven environment. Availability to work after hours, weekends, and holidays on a rotating schedule. Preferred Qualifications reputed company center or telephonic clinical support experience. Compensation & Work Structure Salaried role (40 hours/week) Salary reputed company: $120,000 – $125,000 annually, with potential consideration up to $127,500 for exceptional candidates. Competitive benefits package provided. Additional Notes This role supports a rapidly expanding clinical team in preparation for new reputed company implementations. Start dates are planned for reputed company and November, with full training provided. #J-18808-Ljbffr reputed company™ Apply tot his job Apply To this Job