Remote Clinical Pharmacist – Prior Authorization Expert

HireTalent - Staffing & Recruiting Firm; United States; Remote; USD 110,000 - 150,000; Full time

Job summary

Client is seeking an experienced Clinical Pharmacist to join a remote review team focused on prior authorizations and medication coverage decisions.

The role requires a PharmD and at least 3 years of licensed pharmacist experience, plus prior authorization or clinical review background in managed care or PBMs. Remote work is allowed from approved U.S. states, with one weekend shift after training.

Qualifications

• PharmD degree and US licensure.
• At least 3 years as a licensed pharmacist.
• Experience with prior authorization or clinical reviews in managed care.
• Ability to discuss clinical rationale confidently with physicians.

Responsibilities

• Review prior authorization requests and appeals for specialty and other medications.
• Apply clinical criteria to approve or deny requests.
• Conduct peer-to-peer calls with prescribers to discuss rationale.
• Participate in clinical audits and inter-rater reliability testing.
• Support pharmacy teams with clinical escalations and questions.

Skills

Clinical judgment

Communication with physicians

Prior authorization experience

Pharmacist license

Education

Doctor of Pharmacy (PharmD)

Job description

Client is seeking an experienced Clinical Pharmacist to join a remote review team focused on prior authorizations and medication coverage decisions.

The role requires a PharmD and at least 3 years of licensed pharmacist experience, plus prior authorization or clinical review background in managed care or PBMs. Remote work is allowed from approved U.S. states, with one weekend shift after training.