Job Description
Job Description
A remote Pharmacist opportunity is available for a dedicated professional seeking a 6-month contract-to-hire engagement. This role involves critical review and management of Part B drug and biologic prior authorization requests and appeals, aligned with Medicare guidelines and clinical policies. Candidates licensed in any U.S. state are encouraged to apply, providing flexibility for location.
Location:
- Remote (licensed Pharmacists from any state)
Schedule:
- Monday through Friday, 12:00 PM – 8:30 PM EST
- Mandatory weekend and holiday rotations from 01/01/2027 to 03/31/2027
- No days off except emergencies during rotation period
Key Responsibilities:
- Review and adjudicate Part B drug and biologic prior authorization requests and appeals with clinical precision
- Apply Medicare requirements and utilization management criteria to authorization decisions
- Collaborate with internal clinical and non-clinical teams for policy and workflow support
- Identify process improvement opportunities to enhance review quality and operational efficiency
- Adapt to a dynamic, fast-paced environment with evolving workflows
- Maintain high quality and productivity while managing varying priorities and workload volumes
Qualifications:
- PharmD degree and active pharmacist license in at least one state
- Minimum of 2 years’ experience in utilization management, managed care residency, or specialty pharmacy
- Demonstrated strong clinical judgment with ability to independently assess complex Part B drug requests
- Experience with Part B prior authorization and appeals review preferred
- Prior utilization management and prior authorization background strongly desired
This temp-to-hire position offers a challenging yet rewarding environment for skilled pharmacists who thrive on clinical decision-making and process optimization. If you are looking to leverage your expertise in managed care pharmacy within a flexible, remote setting, apply now to take the next step in your career.
Compensation for this position ranges from $55.00 to $65.00. Eligible candidates may also receive healthcare benefits, housing, and meals/incidentals. Full details of our healthcare benefits plan can be found here. This posting is open for 60 days after the posting date.
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