Remote Clinical Pharmacist

HireTalent; United States; Remote; USD 110,000 - 140,000; Full time

Job summary

HireTalent is seeking experienced remote Clinical Pharmacists to join a dynamic team reviewing medication authorization requests in a managed care setting. You will apply clinical guidelines and collaborate with physicians to support coverage decisions.

Ideal candidates have PharmD, 3+ years of pharmacist experience, and familiarity with prior authorization or utilization management. This 100% remote role operates CST hours and offers ongoing contract extension opportunities.

Qualifications

• Doctor of Pharmacy (PharmD) degree required.
• 3+ years of pharmacist experience.
• Experience with prior authorization and utilization management.
• Experience in health plan, managed care, PBM, or insurance.
• Strong communication with physicians.

Responsibilities

• Review and evaluate prior authorization requests for specialty and non-specialty medications.
• Apply clinical guidelines and medical necessity criteria to make coverage determinations.
• Assess appeals and reconsideration requests.
• Conduct peer-to-peer discussions with prescribing physicians.
• Support quality assurance initiatives and clinical audits.
• Provide expertise to internal teams on pharmacy-related questions.
• Help ensure safe, appropriate, and cost-effective medication use.
• Maintain compliance with all applicable regulations and industry standards.

Education

PharmD

Job description

Join a growing healthcare organization where your clinical expertise directly impacts patient access to life-changing medications.

We are seeking experienced remote Clinical Pharmacists to join a dynamic team responsible for reviewing medication authorization requests and ensuring evidence-based, patient-focused coverage decisions. This is an excellent opportunity for pharmacists who enjoy applying clinical knowledge, collaborating with healthcare providers, and working in a managed care environment.

What You'll Do

• Review and evaluate prior authorization requests for specialty and non-specialty medications
• Apply clinical guidelines and medical necessity criteria to make coverage determinations
• Assess appeals and reconsideration requests
• Conduct peer-to-peer discussions with prescribing physicians when needed
• Support quality assurance initiatives and clinical audits
• Provide expertise and guidance to internal teams on pharmacy-related questions
• Help ensure safe, appropriate, and cost-effective medication use
• Maintain compliance with all applicable regulations and industry standards

What We're Looking For

Required Qualifications

• Doctor of Pharmacy (PharmD)
• 3+ years of pharmacist experience
• Prior authorization, utilization management, or clinical review experience
• Experience working within a health plan, managed care, PBM, or insurance environment
• Strong understanding of clinical criteria and medication coverage decisions
• Excellent communication skills and confidence speaking with physicians and healthcare providers

Preferred Qualifications

• Board Certification (BCPS, BCOP, or similar)
• Pharmacy residency training
• Experience developing or applying clinical review criteria
• Background in retail, hospital, specialty, or managed care pharmacy
• 100% Remote (CST hours)
• Full-time contract, 40 hours per week

Work Location:

• This is a remote position, open to candidates reside in any of the following states: Alabama, Maine, Ohio, Arizona, Maryland, Oregon, Arkansas, Massachusetts, Pennsylvania, Colorado, Michigan, Rhode Island, Connecticut, Minnesota, South Carolina, District of Columbia, Mississippi, South Dakota, Florida, Missouri, Tennessee, Georgia, Nebraska, Texas, Idaho, Nevada, Utah, Illinois, New Hampshire, Vermont, Indiana, New Jersey, Virginia, Iowa, New Mexico, Washington, Kansas, New York, Wisconsin, Kentucky, and North Carolina.

Why This Opportunity?

• Gain valuable prior authorization and managed care experience
• Work remotely from home
• Be part of a collaborative pharmacy operations team
• Opportunity for contract extension and career growth