Remote Pharmacist I - Clinical Prior Authorization

Navitus; Lincoln (NE); Remote; USD 110,000 - 140,000; Full time

Benefits offered by this job

Health insurance

Dental insurance

Vision insurance

Paid time off

Parental leave

401K company match

Adoption Assistance

Flexible Spending Account

Educational Assistance Plan

Professional Membership assistance

Referral Bonus Program

Job summary

Navitus Health Solutions is seeking a Pharmacist I, Clinical Prior Authorization to manage prior authorizations and drug utilization review. The role interfaces with physicians and pharmacists to ensure appropriate, cost-effective therapy and supports client education on clinical issues.

The candidate will review health data, contribute to program development, and participate in ongoing URAC training while supporting operational departments in PBM programs.

Qualifications

• Bachelor’s or PharmD with current, unrestricted pharmacist licensure.
• Two years of clinical or managed care experience preferred.
• Knowledge of PBM, formulary management and claims principles.
• Strong clinical judgment and ability to translate data to practice.

Responsibilities

• Support clinical programs such as Health Management and Prior Authorization.
• Participate in coverage determinations and communicate with prescribers.
• Monitor quality and efficiency of coverage criteria and communications.
• Contribute to clinical content and program maintenance; URAC training.

Skills

Clinical knowledge

Pharmacist licensure

PBM understanding

Clinical judgement

Microsoft Office suite

Education

Bachelor's degree in Pharmacy

PharmD

Tools

Micromedex

Medline

Electronic databases

Job description

Navitus Health Solutions is seeking a Pharmacist I, Clinical Prior Authorization to manage prior authorizations and drug utilization review. The role interfaces with physicians and pharmacists to ensure appropriate, cost-effective therapy and supports client education on clinical issues.

The candidate will review health data, contribute to program development, and participate in ongoing URAC training while supporting operational departments in PBM programs.