Remote Pharmacist – PA/Appeals & Health Equity

ISHE; Portland (ME); Remote; USD 126,078,000 - 226,367,000; Full time

Benefits offered by this job

Paid time off

Medical plan

Dental & Vision

401(k)

Job summary

UnitedHealth Group is hiring a Pharmacist PA/Appeals for remote work with Maine or Vermont residency. The role focuses on prior authorization, appeals review, and ensuring compliant determinations using clinical and benefit criteria.

Required licensure, strong Excel/Office skills, and flexibility for a wide operating window. Telecommuting is available for eligible candidates in Maine or Vermont.

Qualifications

• Pharmacist license (Bachelor or PharmD) and active license in home state.
• Proficiency with Microsoft Excel, Word, Outlook, and Teams.
• Ability to work within the 8:00 AM–8:00 PM window, including weekends and on-call as required.
• Must reside in Maine or Vermont.

Responsibilities

• Review, decision, and process prior authorization and appeals requests using clinical criteria and plan requirements.
• Research medication information and benefit details across systems to support case resolution.
• Communicate with members/providers/pharmacies to clarify requirements and follow up.

Skills

Clinical decision making

Attention to detail

Regulatory knowledge

Communication skills

Education

Bachelor of Pharmacy or Doctor of Pharmacy

Tools

CMS

IEX

CTI

TCS

Job description

UnitedHealth Group is hiring a Pharmacist PA/Appeals for remote work with Maine or Vermont residency. The role focuses on prior authorization, appeals review, and ensuring compliant determinations using clinical and benefit criteria.

Required licensure, strong Excel/Office skills, and flexibility for a wide operating window. Telecommuting is available for eligible candidates in Maine or Vermont.