Remote Clinical Pharmacist: Prior Authorization

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

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.