Remote Appeals Pharmacist — Fair Medication Access

Pharmacy Careers; Virginia Beach (VA); Remote; USD 110,000 - 140,000; Full time

Benefits offered by this job

Remote work options

Comprehensive benefits

Advancement paths

Job summary

Pharmacy Careers invites applications for a Remote Appeals Pharmacist – Fair Medication Access | Work From Home | Strong Clinical Writing Focus. Combine clinical expertise with advocacy in a fully remote role reviewing medication coverage appeals and applying evidence-based guidelines from home with a schedule that supports work-life balance.

Key responsibilities include reviewing clinical documentation, applying plan policies, preparing written rationales, collaborating with physicians and

Qualifications

• PharmD or BPharm degree required.
• Managed care or utilization management experience preferred.
• Strong documentation and clinical skills required.

Responsibilities

• Review medication coverage appeals and grievances.
• Apply plan policies and guidelines to reach determinations.
• Prepare written clinical rationales supporting appeal outcomes.
• Collaborate with physicians, nurses, and medical directors during case reviews.
• Track and report appeal outcomes in compliance with regulations.
• Identify opportunities to improve timeliness and quality.

Skills

Clinical judgment

Written communication

Regulatory attention to detail

Education

PharmD

Bachelor of Pharmacy

Job description

Pharmacy Careers invites applications for a Remote Appeals Pharmacist – Fair Medication Access | Work From Home | Strong Clinical Writing Focus. Combine clinical expertise with advocacy in a fully remote role reviewing medication coverage appeals and applying evidence-based guidelines from home with a schedule that supports work-life balance.

Key responsibilities include reviewing clinical documentation, applying plan policies, preparing written rationales, collaborating with physicians and