Remote Clinical Review Pharmacist – Prior Auth Expert

SmithRx; United States; Remote; USD 88,000 - 91,000; Full time

Job summary

SmithRx is seeking a Clinical Review Pharmacist to join its remote clinical team. You will review prior authorizations and appeals using current guidelines, support clinical programs, and provide guidance to providers, pharmacies, and members in a fast-paced, collaborative environment.

The role requires a PharmD or B.S. in Pharmacy, an active state license, and at least 2 years of pharmacy practice. This is a remote, nationwide position with competitive compensation and benefits.

Qualifications

• Doctor of Pharmacy (PharmD) or Bachelor of Science in Pharmacy from an ACPE-accredited school.
• Active, unrestricted pharmacist license in state of residence.
• Minimum of 2 years of pharmacy practice experience.

Responsibilities

• Review and make timely, evidence-based decisions on prior authorizations and appeals using clinical guidelines and benefit criteria.
• Ensure compliance with federal, state, and internal regulations across applicable lines of businesses.
• Document clinical decisions and maintain thorough records per URAC/NCQA utilization review standards.
• Provide clear, empathetic support to members, prescribers, and pharmacies with professional communication.
• Stay current with prescribing guidelines, internal policies, and regulatory changes and apply them to daily duties.

Skills

PharmD

Active license

2+ years experience

Communication skills

Regulatory knowledge

Education

ACPE-accredited PharmD/B.S. Pharm

Tools

Google Workspace

Job description

SmithRx is seeking a Clinical Review Pharmacist to join its remote clinical team. You will review prior authorizations and appeals using current guidelines, support clinical programs, and provide guidance to providers, pharmacies, and members in a fast-paced, collaborative environment.

The role requires a PharmD or B.S. in Pharmacy, an active state license, and at least 2 years of pharmacy practice. This is a remote, nationwide position with competitive compensation and benefits.