Remote Prior Authorization Pharmacist (3+ yrs exp)

Lancesoft; Woonsocket (RI); Remote; USD 87,000 - 91,000; Full time

Benefits offered by this job

Medical Insurance

Dental and Vision Insurance

401k Contributions

Critical Illness Insurance

Voluntary Permanent Life Insurance

Accident Insurance

Other Employee Perks

Job summary

LanceSoft is seeking a Prior Authorization Pharmacist for a remote, temporary opportunity. The role requires reviewing and adjudicating prior authorization requests, applying guidelines and plan criteria, and collaborating with clinical staff to achieve appropriate, cost-effective therapy.

The position requires an AZ or TX pharmacist license, 3+ years of pharmacist experience, and a PharmD or PharmD-equivalent degree. Comprehensive benefits and a focus on compliance are provided.

Qualifications

• Active and unrestricted AZ or TX pharmacist license.
• Experience applying evidence-based clinical guidelines and formulary criteria.
• Experience in a high-production pharmacist environment.
• 3+ years of experience as a pharmacist.
• Knowledge of clinical program components, formulary designs, and prescription benefit trends.

Responsibilities

• Review, adjudicate, and authorize or deny medication prior authorization requests based on medical necessity and formulary compliance.
• Apply clinical guidelines, drug references, FDA labeling, and plan-specific criteria to decisions.
• Evaluate patient-specific factors such as diagnosis, labs, prior therapy, dosing, and contraindications.
• Document rationale clearly and accurately; maintain documentation in systems.
• Collaborate with technicians, nurses, medical directors, and other staff to resolve complex cases.
• Support peer-to-peer reviews and prepare summaries for escalation when needed.
• Ensure compliance with state/federal regulations and accreditation standards.
• Maintain productivity, turnaround time, and quality benchmarks for processing.
• Document all activities in prior authorization and pharmacy management systems.

Skills

AZ license

TX license

Education

Bachelor's degree in pharmacy

Pharm D

Job description

LanceSoft is seeking a Prior Authorization Pharmacist for a remote, temporary opportunity. The role requires reviewing and adjudicating prior authorization requests, applying guidelines and plan criteria, and collaborating with clinical staff to achieve appropriate, cost-effective therapy.

The position requires an AZ or TX pharmacist license, 3+ years of pharmacist experience, and a PharmD or PharmD-equivalent degree. Comprehensive benefits and a focus on compliance are provided.