Remote Pharmacist

Managed Staffing, Inc.; United States; On-site; USD 110,000 - 150,000; Full time

Job summary

Managed Staffing, Inc. seeks an experienced Pharmacist with strong expertise in Medicare Part D, PA, and PBM processes to review medication requests and determine coverage according to guidelines, formulary requirements, and health plan policies.

The Pharmacist will assess clinical documentation against criteria and support coverage decisions, collaborating with plans to ensure appropriate utilization and patient care.

Qualifications

• PharmD or Bachelor of Pharmacy degree.
• Active and unrestricted Pharmacist license.
• Experience with Prior Authorization and/or Utilization Management.
• Strong understanding of Medicare Part D and pharmacy benefit coverage.
• Experience working with PBMs, health plans, managed care organizations, or insurance providers.
• Knowledge of formularies, step therapy, quantity limits, coverage criteria, and medication utilization management.
• Strong clinical documentation review and decision-making skills.
• Excellent written and verbal communication skills.

Skills

Medicare Part D knowledge

Prior Authorization

Pharmacist license

Utilization Management

PBM experience

Formulary & step therapy

Clinical documentation review

Strong communication

Education

PharmD or Bachelor of Pharmacy

Active and unrestricted Pharmacist license

Job description

We are seeking an experienced Pharmacist with strong knowledge of Medicare Part D, Prior Authorization (PA), and Pharmacy Benefit Management (PBM) processes. The Pharmacist will review medication requests, evaluate clinical documentation against established criteria, and determine coverage based on Medicare guidelines, formulary requirements, and health plan policies.

Required Qualifications

• PharmD or Bachelor of Pharmacy degree.
• Active and unrestricted Pharmacist license.
• Experience with Prior Authorization and/or Utilization Management.
• Strong understanding of Medicare Part D and pharmacy benefit coverage.
• Experience working with PBMs, health plans, managed care organizations, or insurance providers.
• Knowledge of formularies, step therapy, quantity limits, coverage criteria, and medication utilization management.
• Strong clinical documentation review and decision-making skills.
• Excellent written and verbal communication skills.