Remote Prior Authorization Pharmacist
Remote Prior Authorization Pharmacist – Work From Home in Managed Care
A confidential managed care organization is seeking a motivated Remote Prior Authorization Pharmacist to evaluate prescription requests, ensure medical necessity, and improve patient access to safe and effective therapies. This work-from-home position is ideal for pharmacists who want to transition out of retail or hospital settings while building expertise in managed care. Key Responsibilities- Review prior authorization requests for accuracy, appropriateness, and clinical necessity.
- Apply plan criteria, evidence-based guidelines, and regulatory standards to determinations.
- Communicate approval/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.
What You’ll Bring
- Education: Doctor of Pharmacy (PharmD) or Bachelor of Pharmacy degree.
- Licensure: Active and unrestricted pharmacist license in the U.S.
- Experience: Prior authorization, utilization management, or managed care preferred — retail or hospital pharmacists with strong clinical judgment are encouraged to apply.
- Skills: Excellent clinical review, documentation, and communication skills.
Why This Role?
- Flexibility: 100% remote work from home with flexible scheduling options.
- Impact: Directly influence patient access to safe and cost-effective medications.
- Growth: Build specialized skills in utilization management and managed care.
- Rewards: Competitive compensation, benefits, and career advancement opportunities.
About Us
We are a c onfidential healthcare partner working with health plans and PBMs across the U.S. . Our pharmacists ensure patients receive the right therapy at the right time while maintaining compliance with all regulations.
Take the next step in your career with our Remote Prior Authorization Pharmacist opportunity — and enjoy the benefits of working from home while shaping the future of managed care.
Recommended Jobs
Retail Part Time Store Associate
**Overview** As a Part Time Retail Store Associate at Office Depot, your part-time role is vital to our continued success in today's retail landscape. You'll engage with customers in a friendly and kn…
Quarry Maintenance Mechanic- Alexander City, AL (2nd Shift)
APAC-AL, Inc., part of CRH’s South Division, is a leading supplier of quality asphalt and Construction Services in the Southeastern U.S., with operations in Alabama. Working with government agencies,…
Now Hiring: Housekeeping Staff - Renaissance Birmingham Ross Bridge Go
The Renaissance Birmingham Ross Bridge Golf Resort & Spa is seeking dependable and detail-oriented Housekeeping Staff to join our luxury hospitality team. Housekeepers play a vital role in provid…
Full Stack Developer/Lead
Full Stack Developer/Lead **Req number:** R6686 **Employment type:** Full time **Worksite flexibility:** Remote **Who we are** CAI is a global technology services firm with over 8,500 associates world…
NSE/Warehouse
NSE/Warehouse Warehouse/Onsite Company Profile Elwood Staffing is partnering with New South Express (NSE), which is a subsidiary company with Honda Logistics North America (HLNA) and provide…
3 Days a Week Emergency Medicine Physician Opportunity in Oxford, AL
Southeast Medical Group has 53 primary care practices in Georgia, Alabama and Tennessee. Physician's 1st organization w/heavy focus on work-life balance looking to hireBoard Certified Family Medici…
Asset Analyst - Grandbridge Real Estate Capital
The position is described below. If you want to apply, click the Apply Now button at the top or bottom of this page. After you click Apply Now and complete your application, you'll be invited to crea…
Tandem Talk | Past Issues
Light Touch | Home Daily APPLY NOW or call recruiting at 678.496.2648 for more information. WE OFFER: ~$27 hourly ~ First Shift 6AM Start Until Finished ~ Local deliveries ~ Touch Frei…
Assistant General Manager
What began as an idea between two brothers to open a Mexican restaurant has since grown into one of the largest, privately held Taco Bell franchisees in America. At Border Foods, we work with a people…
Wastewater Operator (UnionSprings)
We are looking for a licensed Wastewater Operator to join our team responsible for the operation of wastewater treatment plants. This role involves hands-on operation and maintenance of equipment at …