Remote Medicare Part D Pharmacist - Prior Authorization Pro

A-Line Staffing Solutions

Dallas, Fort Worth (TX, TX)

Remote

USD 62,000 - 84,000

Full time

14 days+

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Job summary

A-Line Staffing Solutions in the United States is seeking a Clinical Pharmacist Advisor specializing in Medicare Part D for a fully remote contract role. You will review and process Part D cases, ensure timely CMS-compliant decisions, and document results with clinical rigor.

The role requires a PharmD or PharmD with license, strong clinical judgment, and proficiency with Word and Excel. Training is provided; after the contract, there is potential to transition to full-time employment based on

Qualifications

Bachelor's degree in Pharmacy or PharmD required.
Active Pharmacist license in good standing in your state of residence.
Ability to work independently in a productivity-driven environment.
Excellent attention to detail and documentation skills.
Experience with Medicare/PBM or clinical review preferred.

Responsibilities

Accurately set up and process Medicare Part D cases and appeals.
Thoroughly review internal notes and clinical documentation for relevant information.
Apply clinical judgment and pharmacy knowledge when reviewing requests.
Evaluate clinical information and decide per CMS Medicare guidelines.
Contact providers when additional clinical information is needed.
Document case reviews, decisions, and outreach clearly and concisely.
Ensure all cases are processed within CMS timelines.
Maintain productivity, quality, and accuracy standards.
Follow work instructions and adapt to evolving processes.