Remote Clinical Pharmacist - Prior Authorizations

Motion Recruitment; United States; Remote; USD 110,000 - 150,000; Full time

Job summary

Motion Recruitment is seeking a Clinical Pharmacist for a remote position with a nationally recognized health insurance client. The role centers on prior authorization reviews, clinical guidance, and ensuring compliant pharmacy practices.

You will review authorization requests, report utilization statistics, support technicians, and apply drug coding and NCPDP adjudication knowledge. Residency in listed states is required; EST/CST time zones preferred.

Qualifications

• Bachelor's degree or higher in pharmacy or related field.
• 3+ years of experience in a related field.
• Licensed NC Pharmacist.

Responsibilities

• Review prior authorization requests and determine coverage for drug products.
• Report utilization review statistics to corporate compliance committees.
• Summarize daily utilization review numbers.
• Track compliance of review cases.
• Provide clinical guidance to pharmacy technicians.
• Knowledge of drug coding (NDC, GCN, GPI, USC) and NCPDP claims adjudication systems.
• Review guideline criteria for prior authorization and non-formulary drugs.
• Ensure and evaluate quality controls and implement opportunities for performance improvement in pharmacy practices.
• Research drug information to support prior authorization reviews.
• Must pass drug test and criminal background check to contract.

Skills

Managed care

Remote work experience

Education

Bachelor's degree or advanced degree

NC Pharmacy license

Job description

Motion Recruitment is seeking a Clinical Pharmacist for a remote position with a nationally recognized health insurance client. The role centers on prior authorization reviews, clinical guidance, and ensuring compliant pharmacy practices.

You will review authorization requests, report utilization statistics, support technicians, and apply drug coding and NCPDP adjudication knowledge. Residency in listed states is required; EST/CST time zones preferred.