Remote Medicaid Prior Authorization Pharmacist

CVS Health Corporation; California (MO); Hybrid; USD 95,000 - 194,000; Full time

Benefits offered by this job

Medical, dental, vision insurance

Retirement savings options

Paid time off

Bonus eligibility

Job summary

CVS Health Corporation is seeking a Medicaid Prior Authorization Pharmacist to support Medicaid Prior Authorization processes in a fully remote role across the United States. The candidate will hold active TX or AZ pharmacist licensure and expect to obtain a secondary license within 90 days.

The position requires 3+ years of pharmacist experience or completion of PGY1 managed care residency, with a focus on evidence-based guidelines, formularies, and prior authorization workflows.

Qualifications

• Active and unrestricted TX and/or AZ pharmacist license.
• New hire must obtain secondary license (AZ or TX) within 90 days of hire.
• Experience with clinical decision-making while applying evidence-based guidelines/criteria; using formularies/preferred drug lists.
• Experience working in a high production, remote team environment.
• 3+ years as a pharmacist or completion of PGY1 managed care residency including prior authorization experience.
• Understanding of clinical program components, formulary designs, and prescription benefit trends.

Responsibilities

• Support Medicaid Prior Authorization as a Clinical Pharmacist.
• Work in a fully remote position open to qualified US candidates with active TX/AZ pharmacist licensure.
• Participate in a schedule including one Saturday every 4-6 weeks and occasional holidays.
• Coordinate with care teams to optimize prior authorization decisions.

Skills

Pharmacist license TX/AZ

Clinical decision-making

Remote high-volume work

Prior authorization experience

Formulary knowledge

Education

BS in Pharmacy or PharmD

Job description

CVS Health Corporation is seeking a Medicaid Prior Authorization Pharmacist to support Medicaid Prior Authorization processes in a fully remote role across the United States. The candidate will hold active TX or AZ pharmacist licensure and expect to obtain a secondary license within 90 days.

The position requires 3+ years of pharmacist experience or completion of PGY1 managed care residency, with a focus on evidence-based guidelines, formularies, and prior authorization workflows.