Job Description
Job Title: Remote Clinical Pharmacist – Prior Authorization (Contract-to-Hire)
Location: Work From Home
Pay Rate: $53 per hour
Shift: 11:00 AM – 7:30 PM EST
Training Schedule: Monday – Friday, 8:00 AM – 4:30 PM EST (Starting 06/02/2025, Duration: 4 weeks)
License Requirement: Must be licensed in the state of North Carolina (can reside in any state)
Safety Sensitive Position
Position Overview:
We are seeking a Remote Clinical Pharmacist to join our Prior Authorization team in a contract-to-hire position. The pharmacist will be responsible for evaluating and reviewing prior authorization requests and making coverage determinations based on clinical criteria and plan design. This is a non-patient-facing role, allowing for 100% remote work.
Key Responsibilities:
Evaluate and review all prior authorization requests , ensuring compliance with clinical guidelines and health plan criteria.
Verify insurance coverage and eligibility , interpret clinical guideline criteria, consult with healthcare providers, and utilize clinical resources.
Communicate coverage decisions effectively and efficiently to healthcare providers, health plans, employers, and patients.
Collaborate with technicians and prior authorization team members to process referrals and collect appropriate clinical/medical data.
Handle inbound and outbound calls with healthcare professionals, answering clinical questions and resolving escalations.
Maintain professional and technical knowledge of drug and disease states for both Specialty and Non-Specialty Pharmacy programs.
Perform additional projects and duties as needed, including attending training sessions and providing on-call support when required.
Qualifications & Requirements:
Bachelor’s degree in Pharmacy or PharmD required .
Must have an active North Carolina pharmacist license (can reside in any state).
Minimum of 2 years of recent experience reviewing and processing prior authorizations in a specialty/skilled clinical setting (e.g., specialty medical office or PBM).
Experience using clinical resources such as Micromedex, Lexicomp, and Clinical Pharmacology.
Prior authorization, call center, and/or clinical pharmacy experience required.
Strong organizational skills with a keen attention to detail.
Ability to prioritize tasks, multitask, and adapt to rapidly changing situations.
Proficiency with MS Office and Windows-based computer applications .
Excellent oral and written communication skills and interpersonal abilities.
Comfortable handling phone calls from pharmacy technicians and providers for clinical information.
Ability to work independently and make clinical decisions efficiently.
Why Join Us?
100% Remote Work – Enjoy the flexibility of working from home.
Competitive Pay – Earn $53 per hour.
Professional Growth – Opportunity for contract-to-hire transition.
Collaborative Team – Work alongside experienced healthcare professionals.
Stable Schedule – Set work hours with dedicated training support.
If you meet the qualifications and are ready to make an impact in the healthcare field, apply today!
Apply Now! Feel free to reach out to Pierce Jones at [email protected] or 586-710-7983
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