Clinical Pharmacist Advisor – Prior Authorization

US Tech Solutions; Rhode Island; On-site; USD 73,000 - 79,000; Full time

Job summary

US Tech Solutions is seeking a Pharmacist – Prior Authorization Advisor for an 11+ month contract in Rhode Island. The role handles inbound physician/member calls, applies clinical criteria for prior authorizations, and supports the Prior Auth and member services teams.

Responsibilities include evaluating PA requests, consulting healthcare providers, and ensuring timely communication of approvals or denials per protocol, with after-hours availability as needed.

Qualifications

• Pharm D. required with active license in the state of residence.
• 2+ years of pharmacist experience in managed care or PBM setting.
• PBM experience and prior authorization knowledge.

Responsibilities

• Evaluate and render coverage determinations based on clinical criteria and plan design.
• Collaborate with technicians and PA team to process referrals and collect clinical data.
• Maintain knowledge of drug/disease state programs within the Commercial Specialty PBM line.
• Attend training and provide on-call after-hours pharmacist availability as needed.

Skills

Managed care

Medicare/Medicaid

Prior Authorization

PBM experience

Education

Pharm D.

Job description

US Tech Solutions is seeking a Pharmacist – Prior Authorization Advisor for an 11+ month contract in Rhode Island. The role handles inbound physician/member calls, applies clinical criteria for prior authorizations, and supports the Prior Auth and member services teams.

Responsibilities include evaluating PA requests, consulting healthcare providers, and ensuring timely communication of approvals or denials per protocol, with after-hours availability as needed.