Pharmacist

Actalent; Birmingham (AL); Remote; USD 104,000 - 114,000; Full time

Benefits offered by this job

Medical, dental & vision

401(k) Retirement Plan

Life Insurance

Disability insurance

Health Spending Account (HSA)

Transportation benefits

Employee Assistance Program

Time Off/Leave

Job summary

Actalent is seeking a Clinical Pharmacist to support prior authorization and appeal reviews, evaluating clinical documentation and making coverage determinations within a PBM-driven environment.

The role requires a PharmD, active pharmacist license, and experience with utilization management and appeals processes. This remote contract position emphasizes accuracy, regulatory compliance, and collaboration with providers.

Qualifications

• PharmD required and licensed pharmacist in good standing.
• Experience with prior authorization reviews, utilization management, or managed care pharmacy.
• Knowledge of PBM operations and payer-specific authorization processes.

Responsibilities

• Review prior authorization and appeal requests for medications and therapies.
• Evaluate clinical documentation and make evidence-based coverage determinations.
• Collaborate with prescribers, pharmacies, and internal stakeholders to obtain necessary clinical information.
• Document coverage decisions accurately and thoroughly.
• Communicate authorization outcomes and clinical rationale to providers and pharmacies.
• Ensure compliance with client requirements, regulatory guidelines, and company policies.
• Support process improvement initiatives to enhance workflow efficiency and quality.

Skills

Clinical Pharmacy

PharmD

Active pharmacist license

Prior Authorization

Pharmacy Benefit Management (PBM)

Managed Care

Appeals Review

Utilization Management

CMS Regulations

Specialty Pharmacy

Education

Doctor of Pharmacy (PharmD)

Tools

PBM platforms

Workflow/case management systems

Job description

• Active pharmacist license in good standing
• Pharmacy Benefit Management (PBM)
• Appeals Review

Clinical Pharmacist

Overview

We are seeking a Clinical Pharmacist to support the review of prior authorization and appeal requests. In this role, you will evaluate clinical documentation, make coverage determinations based on established criteria, and collaborate with healthcare providers, pharmacies, and internal teams to ensure timely and accurate decisions.

The ideal candidate has a strong clinical background, excellent attention to detail, and experience working within managed care, PBM, or prior authorization environments.

Key Responsibilities

• Review prior authorization and appeal requests for medications and therapies
• Evaluate clinical documentation and make evidence-based coverage determinations
• Collaborate with prescribers, pharmacies, and internal stakeholders to obtain necessary clinical information
• Document coverage decisions accurately and thoroughly
• Communicate authorization outcomes and clinical rationale to providers and pharmacies
• Ensure compliance with client requirements, regulatory guidelines, and company policies
• Support process improvement initiatives to enhance workflow efficiency and quality

Qualifications

• Doctor of Pharmacy (PharmD) required
• Active pharmacist license in good standing
• Experience with prior authorization reviews, utilization management, or managed care pharmacy
• Knowledge of pharmacy benefit management (PBM) operations and payer-specific authorization processes
• Strong clinical decision-making and communication skills
• Ability to work effectively in a fast-paced, metrics-driven environment

Preferred Experience

• Experience with multiple PBM platforms and prior authorization workflows
• Familiarity with medical benefit and pharmacy benefit coverage determinations
• Exposure to appeals review processes, including first-level, second-level, or external reviews
• Understanding of managed care, health plan operations, and utilization management practices
• Experience communicating clinical decisions to providers, pharmacies, and members
• Familiarity with specialty medications, including biologics, oncology, immunology, and rare disease therapies
• Knowledge of CMS, state, and payer regulations related to prior authorization
• Experience using workflow, case management, or ticketing systems
• Ability to identify opportunities for process and policy improvements

Skills

• Clinical Pharmacy
• PharmD
• Prior Authorization
• Pharmacy Benefit Management (PBM)
• Managed Care
• Appeals Review
• Utilization Management
• CMS Regulations
• Specialty Pharmacy

Job Type & Location

This is a Contract position based out of Birmingham, AL.

Pay And Benefits

The pay range for this position is $50.00 - $55.00/hr.

Individual compensation offered for this position within this range will depend on many factors, including qualifications, skills, relevant experience, job knowledge, geographic location, internal equity, and other pertinent job-related factors.

Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following:

• Medical, dental & vision
• Critical Illness
• Accident, and Hospital
• 401(k) Retirement Plan Pre-tax and Roth post-tax contributions available
• Life Insurance (Voluntary Life & AD&D for the employee and dependents)
• Short and long-long-term disability
• Health Spending Account (HSA)
• Transportation benefits
• Employee Assistance Program
• Time Off/Leave (PTO, Vacation or Sick Leave)

Workplace Type

This is a fully remote position.

Application Deadline

This position is anticipated to close on Oct 19, 2026.

About Actalent

Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 20,000 consultants and 5,000 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500. We are proud to be an Engineering News-Record (ENR) Top 500 Design Firm for our engineering design services and a ClearlyRated Best of Staffing® winner for both client and talent service.

The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please email [e-mail] for other accommodation options.

San Francisco Fair Chance Ordinance:

Pursuant to the San Francisco Fair Chance Ordinance, for all positions located in the city and county of San Francisco, we will consider for employment qualified applicants with arrest and conviction records.

Massachusetts Lie Detector:

It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.

Use of Artificial Intelligence (AI):

We may use Artificial Intelligence (AI) to support parts of our hiring process, including sourcing, screening, and evaluating candidates. AI helps assess applications and qualifications, but final decisions are made by our hiring team. By applying, you acknowledge and agree that your application may be reviewed using AI tools.