Remote Clinical Pharmacist — Prior Authorization Expert

ASK Consulting; Durham (NC); Remote; USD 81,000 - 87,000; Full time

Job summary

ASK Consulting seeks an experienced Clinical Pharmacist for Prior Authorization to support PBM activities on a 6-month contract. This 100% remote role requires an active pharmacist license in the United States and a minimum of 3 years in clinical pharmacy or prior authorization.

Responsibilities include reviewing PA requests, preparing compliance reports, and guiding pharmacy technicians. Strong knowledge of NDC/GCN/GAI codes and NCPDP claims adjudication is expected.

Qualifications

• Active U.S. Pharmacist license.
• Minimum of 3 years of clinical pharmacy or prior authorization experience.
• Strong knowledge of pharmacy benefit management, utilization review, and prior authorization processes.
• Excellent analytical, communication, and documentation skills.

Responsibilities

• Review prior authorization requests and make coverage determinations based on member benefits and clinical criteria.
• Review and summarize daily utilization review data and prepare reports for corporate compliance committees.
• Track compliance metrics for utilization review cases.
• Provide clinical guidance and support to pharmacy technicians.
• Apply knowledge of drug coding systems (NDC, GCN, GPI, and USC) and NCPDP claims adjudication.
• Review prior authorization and non-formulary drug guidelines to support Pharmacy & Therapeutics Committee initiatives and pharmacy benefit design.
• Ensure quality standards are met and identify opportunities for process and performance improvements.
• Research drug information and maintain current knowledge of medications and disease states to support clinical reviews.

Skills

Analytical skills

Documentation

Communication skills

Clinical knowledge

Education

Bachelor's degree in Pharmacy

PharmD preferred

Job description

ASK Consulting seeks an experienced Clinical Pharmacist for Prior Authorization to support PBM activities on a 6-month contract. This 100% remote role requires an active pharmacist license in the United States and a minimum of 3 years in clinical pharmacy or prior authorization.

Responsibilities include reviewing PA requests, preparing compliance reports, and guiding pharmacy technicians. Strong knowledge of NDC/GCN/GAI codes and NCPDP claims adjudication is expected.