Remote Pharmacist: Utilization Management & PA Reviews

Medix Staffing Solutions, Inc.; Washington; Remote; USD 120,000 - 150,000; Full time

Benefits offered by this job

Paid sick leave

Health benefits / dental / vision

401k

Short term disability insurance

Term life insurance

Job summary

Medix Staffing Solutions, Inc. is seeking a Pharmacist for first-level pharmacy utilization management and prior authorization reviews. This remote role focuses on benefit reviews, applying established guidelines to approve or deny medication requests.

You will process a high volume of cases daily and collaborate with the pharmacy team to support policy initiatives. Requirements include active WA and US pharmacist licenses, strong clinical judgment, and experience in UM or MTM preferred.

Qualifications

• Licensed pharmacist in Washington and the United States in good standing.
• Ability to learn clinical guidelines and apply criteria quickly.
• Experience with high-volume reviews and utilization management preferred.
• Strong written and verbal communication skills; works well under pressure.
• Experience with formulary development and drug utilization management is a plus.

Responsibilities

• Perform first-level pharmacy utilization management and prior authorization reviews.
• Review cases to ensure medications meet clinical and medical policy criteria.
• Approve or deny medication requests per established guidelines.
• Process a high volume of cases daily; ~80–100 when trained.
• Support clinical initiatives and drug utilization management programs.
• Research and analyze clinical cases and medication information.
• Apply clinical judgment for cost-effective utilization.
• Collaborate with pharmacists and internal stakeholders as needed.
• Focus on pharmacy benefit reviews; no peer-to-peer discussions.

Skills

Clinical knowledge

Decision making

Multitasking

Time management

Communication skills

Independence

Team collaboration

NCQA knowledge (preferred)

Education

Active Washington State pharmacist license

Active U.S. pharmacist license

PharmD / MBA / MHA / MPH or equivalent (preferred)

Tools

Microsoft Office

Job description

Medix Staffing Solutions, Inc. is seeking a Pharmacist for first-level pharmacy utilization management and prior authorization reviews. This remote role focuses on benefit reviews, applying established guidelines to approve or deny medication requests.

You will process a high volume of cases daily and collaborate with the pharmacy team to support policy initiatives. Requirements include active WA and US pharmacist licenses, strong clinical judgment, and experience in UM or MTM preferred.