Remote Prior Authorization Pharmacist

Remote, USA Full-time
Job Title: Remote Prior Authorization Pharmacist (PharmD Required) Location: Fully Remote (Work from Home, Florida) Key Responsibilities: • Conduct thorough utilization management reviews, including prior authorizations, appeals, and denials for prescription medications. • Apply clinical knowledge to evaluate requests against insurance policies, FDA guidelines, and evidence-based medicine. • Communicate decisions effectively to healthcare providers, patients, and internal teams via phone, email, or secure portals. • Document all reviews accurately in electronic systems to ensure compliance with CMS, state regulations, and health plan policies. • Collaborate with medical directors and utilization management teams on complex cases to optimize patient outcomes. • Contribute to process improvements for faster turnaround times in prior authorization workflows. Qualifications and Requirements: • Doctor of Pharmacy (PharmD) degree from an accredited institution. 20 • Active, unrestricted pharmacist license in at least one U.S. state (multi-state licensure preferred for remote work). • 1-3 years of experience in clinical pharmacy, prior authorization, or managed care (entry-level considered for strong candidates). • Proficiency in pharmacology, insurance verification, and electronic health records (EHR) systems. • Strong communication, analytical, and problem-solving skills for handling remote pharmacist duties. • Reliable home office setup with high-speed internet for secure, confidential work. Job Types: Full-time, Contract Pay: $60.65 - $65.04 per hour Expected hours: No less than 40 per week Benefits: • Flexible schedule Education: • Doctorate (Required) License/Certification: • Licensed Pharmacist (Required) Location: • Florida (Required) Work Location: Remote Apply tot his job
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