Clinical Pharmacist

HireTalent - Staffing & Recruiting Firm; United States; Remote; USD 110,000 - 150,000; Full time

Job summary

Client is seeking an experienced Clinical Pharmacist to join a remote review team focused on prior authorizations and medication coverage decisions.

The role requires a PharmD and at least 3 years of licensed pharmacist experience, plus prior authorization or clinical review background in managed care or PBMs. Remote work is allowed from approved U.S. states, with one weekend shift after training.

Qualifications

• PharmD degree and US licensure.
• At least 3 years as a licensed pharmacist.
• Experience with prior authorization or clinical reviews in managed care.
• Ability to discuss clinical rationale confidently with physicians.

Responsibilities

• Review prior authorization requests and appeals for specialty and other medications.
• Apply clinical criteria to approve or deny requests.
• Conduct peer-to-peer calls with prescribers to discuss rationale.
• Participate in clinical audits and inter-rater reliability testing.
• Support pharmacy teams with clinical escalations and questions.

Skills

Clinical judgment

Communication with physicians

Prior authorization experience

Pharmacist license

Education

Doctor of Pharmacy (PharmD)

Job description

Looking for a Clinical Pharmacist role where your expertise directly influences medication access and patient care? Our Client is seeking experienced pharmacists to join a clinical review team focused on prior authorizations and medication coverage decisions.

What You’ll Do:

• Review prior authorization requests and appeals for specialty, non-specialty, and physician-administered medications.
• Apply clinical criteria to make appropriate approval or denial determinations.
• Conduct peer-to-peer calls with prescribers to discuss clinical rationale for adverse decisions.
• Participate in clinical audits and inter-rater reliability testing.
• Support pharmacy teams with clinical escalations and questions.

What You’ll Bring:

• PharmD (Doctor of Pharmacy) degree.
• 3+ years of experience as a licensed pharmacist.
• Prior authorization or clinical review experience, ideally in managed care, health plans, PBMs, or insurance.
• Strong clinical judgment and ability to communicate confidently with physicians.

Location:

100% Remote — must reside in an approved U.S. state. One weekend shift per week is required after the initial training period.