Remote Pharmacist: Prior Authorization & Appeals
UnitedHealth Group
- Remote job
UnitedHealth Group seeks a Pharmacist PA/Appeals for remote work supporting Vermont and Maine. The role focuses on clinical review, decisioning, and appeals in pharmacy prior authorization, with collaboration across providers, members, and internal teams. Responsibilities include applying policy criteria, documenting rationale, and ensuring HIPAA compliance in a fast-paced, service-driven environment. The position offers telecommuting flexibility within Vermont and Maine and requires licensure #J-18808-Ljbffr UnitedHealth Group
- A healthcare management company is seeking a Remote Coverage Review Pharmacist located in Tennessee. This role requires a Doctor of Pharmacy... ...be responsible for reviewing medication-related prior authorizations, appeals, and grievances, working independently or in a team...Remote work
$44 - $79 per hour
...Pharmacist At UnitedHealthcare, we're simplifying the health care experience, creating... ...interactions, and clinical status for appeals requests Conduct Quality Assurance... ...~1+ years of experience of prior authorization case review & rendering PA decisions...Remote workHourly payMinimum wageFull timeWork experience placementLocal areaMonday to Friday- UnitedHealth Group is seeking a Pharmacist PA/Appeals for remote work in Maine and Vermont. The role involves clinical review, decisioning, and communication related to prior authorization and appeals, using established criteria and regulatory guidelines. You will collaborate...Remote job
- UnitedHealth Group seeks a Pharmacist PA/Appeals to join as a remote clinician supporting Vermont and Maine operations. The role focuses on prior authorization reviews, appeals determinations, and collaboration with providers, members, and internal teams to ensure compliant...Remote jobHome office
$59 per hour
...Job Description Job Description Remote Prior Authorization and Appeals Pharmacist Compensation: $59/hr Duration : 6 – 10 months, contract to hire possible Start date: ASAP. rolling start dates between September and November Location : Fully Remote, candidates...Remote workContract workLocal areaImmediate startShift work$40.87 - $80.43 per hour
...Pharmacist At UnitedHealthcare, we're simplifying the health... ...enjoy the flexibility to work remotely* from anywhere within the U... ..., and clinical status for appeals requests Conduct Quality... ...in Coverage Determinations (prior authorization) or member appeals...Remote jobHourly payWork experience placement$101.6k - $133k
...reviewing clinical coverage determination and appeals for different lines of business such as... ...detailed and thorough documentation in prior authorization cases, appeals cases, and overrides.... ...supervision, stay productive in a remote, high-volume, metric driven environment...Remote workTemporary workWork at officeLocal areaFlexible hoursShift work$44 - $79 per hour
...Pharmacist PA/Appeals - Remote in Vermont & Maine Optum is a global organization that delivers care, aided by technology to help millions... ...start Caring. Connecting. Growing together. As a Prior Authorization Pharmacist, you will support clinical review, decisioning...Remote jobHourly payMinimum wageFull timeTemporary workWork experience placementLocal areaMonday to FridayFlexible hoursShift work$128k - $160k
...Summary Acts as subject matter expert on prior authorization and appeals operations that are compliant to... ...processes of prior authorization pharmacists, staff schedules, skilling, performance... ...year of leadership experience in a remote environment. This position description...Remote workContract workWork at officeLocal areaMonday to FridayFlexible hoursShift workWeekend work- ...Remote Appeals Pharmacist - Fair Medication Access | Work From Home | Strong Clinical Writing Focus Combine clinical expertise with advocacy in a fully remote Appeals Pharmacist role. Review medication coverage appeals, apply evidence-based guidelines, and ensure fair...Remote workWork from home
- ...Remote Case Management Pharmacist Coordinate care for complex patients | Work from home support high-risk and complex patients through... ...concerns, or potential interactions. Support prior-authorization and appeals processes when needed. Educate patients and caregivers...Remote work
- ...About the job Remote Coverage Review Pharmacist Remote Coverage Review Pharmacist needs 3 years and Doctor... ...activities associated with coverage reviews and appeals including the review of medication related prior authorizations, pharmacy appeals, and member grievances...Remote workWork at office
- ...Remote, TX Contract Job Title: Prior Authorization Pharmacist Location:Remote Duration: 6+ months contract Job Description: ~ Responsible for reviewing... ...calls regarding prior authorization and appeals? About US Tech Solutions: US Tech Solutions...Remote workContract work
- Judi Health is seeking a Clinical Appeals Reviewer to review coverage determinations and appeals for Commercial and Medicare lines, ensuring... ...with thorough detail, while maintaining turnaround times in a remote environment. This remote role allows you to work from a secure...Remote jobWork from homeHome office
$50 - $55 per hour
...OVERVIEW Location: Work from home (100% remote) - refer list of states below.... ...retrospective drug utilization review and appeals per State and Federal regulations. Participates... .... JOB RESPONSIBILITIES Provides prior authorization services for formulary drugs, develops...Remote workContract workWork from home$134.32k - $164.09k
...medication access by assisting with prior authorizations, drug therapy appeals, financial assistance, and other... ...medication needs or, Clinical Pharmacist hospital practice experience (2 years... ...or weekly onsite attendance. Remote Type Hybrid Work Location...Remote workFull timeWork at officeImmediate startWork from homeFlexible hoursShift work2 days per week1 day per week$23 per hour
...Pharmacy Prior Authorization Specialist - Onco360 Pharmacy Albuquerque... ...is a full-time position. Remote work if licensed in State of... ...authorization requests and appeals with insurance carriers.... ...Collaborate with physicians, pharmacists, and other departments....Remote workFull timeTemporary workRelocation package$60 - $70 per hour
...and Patient Care! Location: Remote - U.S. (All States... ...recruiting several clinical Pharmacists to support a leading national... ...process for pharmacy drug authorizations and appeals . This fully remote opportunity... ...clinical determinations for prior authorization and appeal...Remote workContract workTemporary workFlexible hoursShift workWeekend work$120k - $125k
...Overview The Clinical Care Pharmacist plays a vital role in ensuring... ...responsible for reviewing prior authorization requests, supporting clinical... ...Location & Schedule Location: Remote Shifts 7a-4p EST 9a-6p... ...decisions on prior authorizations, appeals, and override requests in...Remote jobFull timeContract workShift workWeekend work- ...Non-Billable Orientation (NBO) Job - Remote Managed Care Pharmacist Pharmacist License Required for WA, OR, or CA. 3+ Years in... ...Managed Care Environment Required (meaning dealing with Prior Authorizations, Audits, Appeals, ALJ Court hearings, etc). Rare weekends required...Remote workLocal areaWeekend work
- ..., knowledgeable, and highly trained pharmacists and support staff, plays a critical... ...benefits investigations, coordinating prior authorizations and appeals, and ensuring timely patient access... ...pay differential may be applied for remote employees who reside out of state. Scripps...Remote workFull timeWork at officeMonday to FridayShift work
- UnitedHealth Group is seeking a Senior Pharmacy PA/Appeals Technician to support prior authorization and appeals processes. The role involves handling inquiries... ...systems, and ensuring complete documentation. Remote work available for Maine or Vermont residents, with 8...Remote jobShift workWeekend work
- ...Position Title: Clinical Pharmacist 1 Work Location: Remote Assignment Duration: 3 Months Work... ...Position Summary: Pharmacy Appeals Department - Dept 247 Inclusive... ...the Role * Reviews a completed prior authorization request received from the...Remote workWork at office
- ...Prior Authorization Clinical Pharmacist Virtual: This role enables associates to work virtually full-time, with the exception of required in-person... ...United States when conducting utilization review or an appeals consideration and cannot be located on a US military base...Remote workFull timeContract workWork experience placementWork at office
$75 per hour
...Jack Dorsey . Position: Pharmacy Prior Authorization & Specialty-Medication Access Specialist... ...Compensation: $75/hour Location: Remote Role Responsibilities Process and... ...medication authorisations. Manage appeals for denied pharmacy authorisations, including...Remote workContract workSummer work- ...verifying insurance eligibility, facilitating prior authorizations, and collaborating with third-party... ...to medications and assists with denial appeals and financial assistance through... ...General Circle Tampa 33601 Eligible for Remote Work: Hybrid RemoteJobPharmacyOrganizationFlorida...Remote workShift workDay shift
$135k - $145k
...Utilization Management Pharmacist Trainer Charlotte, North Carolina... ...sessions for pharmacists on prior authorization systems, processes, and... ...clinical prior authorization and appeals determinations in accordance... ..., staying productive in a remote, high-volume, and metric...Remote workWork at officeLocal areaFlexible hours- ...projects. Monitors and oversees Prior Authorization and Appeals. Serves as primary point of contact... ...Doctor of Pharmacy or Registered Pharmacist degree from an ACPE accredited institution... ...of the job. Benefits: Hybrid, remote and flexible on-site work schedules...Remote workFull timeTemporary workPart timeWork at officeLocal areaFlexible hours
$128k - $160k
...Supervisor, Utilization Management Pharmacist Charlotte, North Carolina... ...hands-on clinical work like prior authorizations and provider outreach. You'... ...impactall in a fully remote, high-performing, and collaborative... ...prior authorization and appeal reviews, override requests,...Remote workLocal areaFlexible hoursNight shift$60 - $65 per hour
...Job Title: Clinical Pharmacist I Duration: Contract (3 Months) Location: Remote Schedule: Monday Friday | 9:00 AM 6:00 PM EST... ...Pharmacist I to join a remote Pharmacy Appeals team. In this role, you will review prior authorization and appeal requests to help ensure...Remote workHourly payContract workWork at officeMonday to Friday
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