Remote Clinical Pharmacist: Prior Authorization & Appeals

Actalent; Birmingham (AL); Remote; USD 69,000 - 76,000; Full time

Benefits offered by this job

Medical, dental & vision

401(k) Retirement Plan

Life Insurance

Disability insurance

Health Spending Account

Job summary

Actalent is seeking a clinical Pharmacist for a 100% remote, contract role based out of Birmingham, AL. You will review prior authorization requests, evaluate clinical documentation, and determine coverage while collaborating with prescribers, pharmacies, and internal teams to gather necessary information.

Strong knowledge of PBM systems and CMS/state regulations is required. This role emphasizes accuracy, regulatory compliance, and process improvements within the prior authorization program.

Qualifications

• Active pharmacist license in the state of residence.
• Prior authorization review experience preferred.
• Ability to work efficiently in a production-driven environment.
• Strong attention to detail with a commitment to accuracy and quality.
• Excellent verbal, written, organizational, and interpersonal communication skills.
• Proficiency with technology and digital platforms (e.g., Microsoft Office, shared documentation tools, PBM systems).

Responsibilities

• Review prior authorization and appeal requests.
• Evaluate clinical documentation and make coverage determinations.
• Collaborate with prescribers, pharmacies, and internal teams to obtain necessary clinical information.
• Document decisions and communicate outcomes.
• Ensure compliance with applicable regulatory and client requirements.
• Contribute to process improvements within the prior authorization program.

Skills

Active pharmacist license

Prior authorization review

Production-driven

Attention to detail

Verbal and written communication

Organizational skills

Education

PharmD or Doctor of Pharmacy

Tools

PBM platforms

MS Office

Documentation tools

Case management systems

Job description

Actalent is seeking a clinical Pharmacist for a 100% remote, contract role based out of Birmingham, AL. You will review prior authorization requests, evaluate clinical documentation, and determine coverage while collaborating with prescribers, pharmacies, and internal teams to gather necessary information.

Strong knowledge of PBM systems and CMS/state regulations is required. This role emphasizes accuracy, regulatory compliance, and process improvements within the prior authorization program.