Remote Prior Authorization Pharmacist

Pharmacy Careers; Emmendingen (Kernstadt); Remote; EUR 40.000 - 60.000; Vollzeit

Zusammenfassung

A confidential managed care organization is seeking a motivated Remote Prior Authorization Pharmacist. This role involves evaluating prescription requests, ensuring medical necessity, and improving patient access to therapies—all while working from home with flexible scheduling. Ideal for pharmacists transitioning from retail or hospital settings, the position offers competitive compensation and growth opportunities in managed care.

Leistungen

100% remote work

Flexible scheduling options

Competitive compensation

Career advancement opportunities

Qualifikationen

• Active and unrestricted pharmacist license in the U.S.
• Experience in prior authorization or managed care preferred.
• Retail or hospital pharmacists with strong clinical judgment are encouraged.

Aufgaben

• Review prior authorization requests for accuracy and necessity.
• Apply plan criteria and guidelines to determinations.
• Communicate decisions clearly to providers and patients.
• Collaborate with physicians and medical directors on complex cases.
• Document outcomes compliant with health-plan policies.
• Support process improvements for workflow.

Kenntnisse

Excellent clinical review

Documentation skills

Communication skills

Ausbildung

Doctor of Pharmacy (PharmD) or Bachelor of Pharmacy degree

Jobbeschreibung

Remote Prior Authorization Pharmacist – Work From Home in Managed Care

A confidential managed care organization is seeking a motivated Remote Prior Authorization Pharmacist to evaluate prescription requests, ensure medical necessity, and improve patient access to safe and effective therapies. This work‑from‑home position is ideal for pharmacists who want to transition out of retail or hospital settings while building expertise in managed care.

Key Responsibilities

• Review prior authorization requests for accuracy, appropriateness, and clinical necessity.
• Apply plan criteria, evidence‑based guidelines, and regulatory standards to determinations.
• Communicate approval/denial decisions clearly to providers and patients.
• Collaborate with physicians, nurses, and medical directors on complex cases.
• Document outcomes in compliance with health‑plan policies and CMS/state regulations.
• Support process improvements to streamline workflow and turnaround times.

What You’ll Bring

• Education: Doctor of Pharmacy (PharmD) or Bachelor of Pharmacy degree.
• Licensure: Active and unrestricted pharmacist license in the U.S.
• Experience: Prior authorization, utilization management, or managed care preferred — retail or hospital pharmacists with strong clinical judgment are encouraged to apply.
• Skills: Excellent clinical review, documentation, and communication skills.

Why This Role?

• Flexibility: 100% remote work from home with flexible scheduling options.
• Impact: Directly influence patient access to safe and cost‑effective medications.
• Growth: Build specialized skills in utilization management and managed care.
• Rewards: Competitive compensation, benefits, and career advancement opportunities.

About Us

We are a confidential healthcare partner working with health plans and PBMs across the U.S. Our pharmacists ensure patients receive the right therapy at the right time while maintaining compliance with all regulations.

Apply Today

Take the next step in your career with our Remote Prior Authorization Pharmacist opportunity — and enjoy the benefits of working from home while shaping the future of managed care.