Remote Prior Authorization Pharmacist — Drive Access

Pharmacy Careers; Passaic (NJ); Remote; USD 120,000 - 140,000; Full time

Benefits offered by this job

Flexible scheduling

Competitive compensation

Job summary

Confidential Healthcare Partner is seeking a Remote Prior Authorization Pharmacist to evaluate prescription requests and ensure medical necessity. This 100% remote role focuses on managed care, CMS/state regulation compliance, and improving patient access to therapies.

Ideal candidates hold a PharmD or equivalent, a U.S. pharmacist license, and have experience with prior authorization or utilization management. Flexible scheduling and a competitive benefits package are offered.

Qualifications

• PharmD or PharmD-equivalent degree required.
• Active and unrestricted pharmacist license in the U.S. needed.
• Experience in prior authorization, utilization management, or managed care preferred.

Responsibilities

• Review prior authorization requests for accuracy and medical necessity.
• Apply plan criteria, evidence-based guidelines, and regulatory standards to determinations.
• Communicate approval or denial decisions clearly to providers and patients.
• Collaborate with physicians, nurses, and medical directors on complex cases.
• Document outcomes in compliance with health plan policies and CMS/state regulations.
• Support process improvements to streamline workflow and turnaround times.

Skills

Clinical review

Documentation

Communication

Education

PharmD or Pharm degree

Job description

Confidential Healthcare Partner is seeking a Remote Prior Authorization Pharmacist to evaluate prescription requests and ensure medical necessity. This 100% remote role focuses on managed care, CMS/state regulation compliance, and improving patient access to therapies.

Ideal candidates hold a PharmD or equivalent, a U.S. pharmacist license, and have experience with prior authorization or utilization management. Flexible scheduling and a competitive benefits package are offered.