Remote Pharmacist for PBM & Prior Authorizations

Actalent; Eagan (MN); Remote; USD 63,000 - 89,000; Full time

Benefits offered by this job

Medical, dental & vision

401(k) Retirement Plan

PTO / Vacation

Job summary

Actalent is seeking a Pharmacist I for a fully remote role based in the United States, with location tied to Eagan, MN for contract-to-hire purposes. The pharmacist will review Medicaid Utilization Management requests, including formulary exceptions and prior authorizations, and communicate with prescribers via multiple channels.

You will apply clinical judgment, maintain documentation accuracy, and adapt to evolving policies.

Qualifications

• Pharmacist degree is required and licensed to practice in the US.
• Experience with PBM or prior authorization processes is preferred.
• Retail pharmacy experience is highly preferred over hospital-based roles.

Responsibilities

• Review Utilization Management requests for Medicaid members, including formulary exceptions, prior authorization, step therapy, and quantity limit exceptions.
• Apply criteria and clinical judgment to determine approvals/denials of prior authorization requests.
• Document clinical decisions clearly in systems meeting policy and regulatory requirements.
• Communicate with prescribers and providers via phone, fax, and electronic systems; handle high volume of calls.
• Use PBM tools to process requests efficiently while maintaining quality metrics.
• Maintain production and quality standards and participate in training for specialized cases.

Skills

Pharmacist license

PBM experience

Retail pharmacy experience

Clinical decision making

Prior authorization processes

Multi-monitor setup

Typing 35 wpm

MS Word & Excel

Education

Doctor of Pharmacy (PharmD)

BS in Pharmacy

Tools

PBM systems

Job description

Actalent is seeking a Pharmacist I for a fully remote role based in the United States, with location tied to Eagan, MN for contract-to-hire purposes. The pharmacist will review Medicaid Utilization Management requests, including formulary exceptions and prior authorizations, and communicate with prescribers via multiple channels.

You will apply clinical judgment, maintain documentation accuracy, and adapt to evolving policies.