Remote Prior Authorization Pharmacist - Clinical Review

MedOp Solutions; United States; Remote; USD 70,000 - 95,000; Full time

Job summary

MedOp Solutions is seeking a remote Pharmacist to perform complex prior authorization reviews and clinical determinations. You will collaborate with prescribers, conduct peer-to-peer calls, and contribute to quality audits while ensuring safe medication use.

The role requires a PharmD with 3+ years as a licensed pharmacist, willingness to obtain additional state licenses, and strong knowledge of PBM processes. This is a remote position available in approved states.

Qualifications

• PharmD required.
• 3+ years licensed pharmacist experience.
• Willingness to obtain additional state licenses or training.

Responsibilities

• Review and determine prior authorization requests for medications under the pharmacy benefit.
• Conduct peer-to-peer calls with prescribers regarding adverse determinations.
• Participate in clinical quality audits and inter-rater reliability testing.
• Support internal teams with pharmacy escalations and clinical questions.
• Apply clinical expertise to ensure appropriate and safe medication use.
• Maintain compliance with all applicable laws and regulations.

Skills

Clinical decision making

Peer-to-peer communication

Regulatory compliance

License readiness

Education

Doctor of Pharmacy (PharmD)

Tools

PBM systems

Job description

MedOp Solutions is seeking a remote Pharmacist to perform complex prior authorization reviews and clinical determinations. You will collaborate with prescribers, conduct peer-to-peer calls, and contribute to quality audits while ensuring safe medication use.

The role requires a PharmD with 3+ years as a licensed pharmacist, willingness to obtain additional state licenses, and strong knowledge of PBM processes. This is a remote position available in approved states.