Remote Prior Authorization Pharmacist – AZ/TX License

VIVA USA Inc; United States; Remote; USD 110,000 - 150,000; Full time

Job summary

VIVA USA Inc. is hiring a Prior Authorization Pharmacist for a fully remote role.

You will review and adjudicate medication prior authorization requests, applying evidence-based guidelines, FDA labeling, and plan-specific criteria to ensure medical necessity and formulary compliance while balancing utilization objectives. The position requires an active AZ or TX license, 3+ years of pharmacist experience, and strong collaboration with clinical staff to resolve complex cases.

Qualifications

• Active and unrestricted AZ or TX pharmacist license.
• Experience applying evidence-based guidelines and formulary/criteria.
• Experience in high production team environment.

Responsibilities

• Review and adjudicate prior authorization requests for medical necessity and formulary compliance.
• Apply guidelines, drug compendia, FDA labeling, and plan-specific criteria.
• Evaluate patient factors and justify decisions with clinical rationale.
• Authorize, modify, or deny requests and document rationale clearly.
• Collaborate with technicians, nurses, medical directors and staff on complex cases.
• Support peer-to-peer reviews and prepare clinical summaries when escalation is required.
• Ensure compliance with regulations, accreditation standards, and internal audits.
• Maintain productivity, turnaround time, and quality benchmarks for processing.

Skills

AZ/TX license

Clinical decision-making

High production team experience

3+ years pharmacist experience

Formulary knowledge/benefit trends

Education

PharmD or Pharm D equivalent

Active license in good standing

Job description

VIVA USA Inc. is hiring a Prior Authorization Pharmacist for a fully remote role.

You will review and adjudicate medication prior authorization requests, applying evidence-based guidelines, FDA labeling, and plan-specific criteria to ensure medical necessity and formulary compliance while balancing utilization objectives. The position requires an active AZ or TX license, 3+ years of pharmacist experience, and strong collaboration with clinical staff to resolve complex cases.