Remote PA Pharmacist – Drive Patient Access

Pharmacy Careers; Annandale (VA); Remote; USD 110,000 - 150,000; Full time

Job summary

Pharmacy Careers is seeking a Remote Prior Authorization Pharmacist to assess prescription requests for medical necessity within managed care frameworks. You will review cases, apply plan criteria, and document decisions while collaborating with providers and care teams.

The role offers 100% remote work with flexible scheduling, opportunities to specialize in utilization management, and a pathway to advance within a growing managed care organization.

Qualifications

• Education: Doctor of Pharmacy (PharmD) or Bachelor of Pharmacy degree.
• Licensure: Active and unrestricted pharmacist license in the U.S.
• Experience: Prior authorization, utilization management, or managed care preferred.
• Skills: Excellent clinical review, documentation, and communication skills.

Responsibilities

• Review prior authorization requests for accuracy, appropriateness, and clinical necessity.
• Apply plan criteria, evidence-based guidelines, and regulatory standards to determinations.
• Communicate approval/denial decisions clearly to providers and patients.
• Collaborate with physicians, nurses, and medical directors on complex cases.
• Document outcomes in compliance with health plan policies and CMS/state regulations.
• Support process improvements to streamline workflow and turnaround times.

Skills

Prior authorization

Utilization management

Managed care

Clinical judgment

Education

PharmD

Bachelor of Pharmacy

Job description

Pharmacy Careers is seeking a Remote Prior Authorization Pharmacist to assess prescription requests for medical necessity within managed care frameworks. You will review cases, apply plan criteria, and document decisions while collaborating with providers and care teams.

The role offers 100% remote work with flexible scheduling, opportunities to specialize in utilization management, and a pathway to advance within a growing managed care organization.