Remote PA Pharmacist – Impact in Managed Care

Pharmacy Careers; Simpsonville (SC); Remote; USD 90,000 - 120,000; Full time

Job summary

Pharmacy Careers hires a Remote Prior Authorization Pharmacist to evaluate prescription requests for medical necessity in a managed care setting. This 100% work-from-home role emphasizes clinical review, documentation, and collaboration with providers to improve patient access to safe therapies.

The ideal candidate holds a PharmD or equivalent, an active U.S. license, and prior authorization or utilization management experience. Flexible scheduling and career growth opportunities are offered.

Qualifications

• Doctor of Pharmacy (PharmD) or Bachelor of Pharmacy degree.
• Active and unrestricted pharmacist license in the U.S.
• Experience in prior authorization, utilization management, or managed care preferred.

Responsibilities

• Review prior authorization requests for accuracy and clinical necessity.
• Apply plan criteria and evidence-based guidelines to determinations.
• Communicate approval/denial decisions to providers and patients.
• Collaborate with physicians and other staff on complex cases.
• Document outcomes in compliance with policies and CMS/state regulations.
• Support process improvements to streamline workflow.

Skills

Clinical review

Documentation

Communication

Education

PharmD or Bachelor of Pharmacy

Job description

Pharmacy Careers hires a Remote Prior Authorization Pharmacist to evaluate prescription requests for medical necessity in a managed care setting. This 100% work-from-home role emphasizes clinical review, documentation, and collaboration with providers to improve patient access to safe therapies.

The ideal candidate holds a PharmD or equivalent, an active U.S. license, and prior authorization or utilization management experience. Flexible scheduling and career growth opportunities are offered.