Remote Prior Authorization Pharmacist — Clinical Reviews
Medix Staffing Solutions, Inc.
- Remote job
Medix is seeking a remote Clinical Pharmacist to evaluate prior authorization requests for formulary and non-formulary medications. You will use evidence-based guidelines and regulatory standards to render timely clinical determinations while collaborating with providers, pharmacies, and health plan teams. This full-time role requires an active Pharmacist license, PA review experience in PBM or health plan settings, and strong communication skills to document rationale and explain decisions. #J-18808-Ljbffr Medix Staffing Solutions, Inc.
$57 per hour
...ProPivotal Staffing is seeking a Clinical Pharmacist Reviewer to work from home in Massachusetts. This role supports clinical pharmacy services and involves optimizing treatments with healthcare teams. Candidates should have 1-2 years of experience and an active Massachusetts...Remote workHourly payWork from homeFlexible hours- MedOp Solutions is seeking a remote Pharmacist to perform complex prior authorization reviews and clinical determinations. You will collaborate with prescribers, conduct peer-to-peer calls, and contribute to quality audits while ensuring safe medication use. The role requires...Remote job
$70 per hour
...developing next-generation clinical AI systems. We’re... ...experienced, licensed US Pharmacists to help improve AI-powered prior authorization workflows by answering... ...clinical questions and reviewing AI-generated responses... ...clinical accuracy. This remote, contractor role in the...Remote jobHourly payFor contractors- ...The Clinical Pharmacy Reviewer (Pharmacist) evaluates complex prior authorization requests, appeals, and medication coverage determinations to ensure clinical appropriateness... ...Why Join Dane Street? - Collaborative remote culture - Professional growth opportunities -...Remote workFull timeLocal areaWork from home
$64 - $66 per hour
...Job Summary: Joining SmithRx’s clinical team, the Clinical Review Pharmacist plays a key role in enhancing clinical... ...service excellence to review prior authorization requests, support clinical... ...Sheets, and Drive) Location: US - Remote Zone A includes the following locations...Remote workFull timeContract workFlexible hoursWeekend work- ...UNITAS provides clinical staffing and consulting solutions, including contract staff... ...clinicians! About the role The Clinical Pharmacist is responsible for the processing and... ...Utilization Management (UM) requests (e.g. prior authorization, step therapy, formulary exceptions)...Remote workPermanent employmentContract workLocal area
- A healthcare solutions provider is seeking a Remote Pharmacist to conduct VA quality reviews, focusing on clinical assessments without direct patient interaction. Candidates must have a Doctor of Pharmacy (PharmD) and an active pharmacist license in the U.S. Responsibilities...Remote workFlexible hours
- ...Remote Clinical Review Pharmacist – Work From HomeLeverage your clinical knowledge in a fully remote Clinical Review Pharmacist role. Evaluate prescriptions and treatment plans for safety, appropriateness, and cost-effectiveness while working from home.Key ResponsibilitiesReview...Remote workWork from homeFlexible hours
- ...vertical, has a contract opening for a Clinical Pharmacist. They have over 4 million customers... ...Location: ** While the position is Remote, work from home, you must reside in... ...home experience Description/Comment: Review prior authorization requests and make determinations for...Remote workContract workWork from home
$101.34k - $126.67k
...CT Rotating holidays and weekends Remote Work Notification ATTENTION: Navitus... ...Health Solutions is seeking a Pharmacist I, Clinical Prior Authorization to join our team! The Pharmacist... ...duties related to Drug Utilization Review including concurrent, retrospective...Remote workFull timeWork experience placementFlexible hours$70 per hour
...Clinical PharmacistMake an impact in healthcare from the comfort of... ...seeking a detail-oriented Clinical Pharmacist who is passionate about... ...quality pharmacy care through prior authorization reviews and clinical decision-making.Location: Remote (North Carolina Resident...Remote workTemporary workWork from homeMonday to FridayDay shift$60 per hour
...Now Hiring: Clinical Pharmacist (Remote) Join Oscar Health and play a key role in supporting evidence-based medication coverage... ...the first 2 months What You'll Do Review and evaluate prior authorization requests and appeals Apply clinical criteria...Remote workContract workImmediate startShift workWeekend work- ...environments, including remote work opportunities.... ...dedicated team.Claims Clinical Documentation ReviewerDivision... ...Documentation Reviewer reports to the Prepayment... ...exception is properly authorized in advance.Knowledge,... ...and implementation, prior authorization functions...Remote workFull timePart timeInternshipWork at officeWork from homeLong distanceFlexible hours
- ...SmithRx, a US remote health-tech company, is seeking a Clinical Review Pharmacist to review prior authorization requests and provide guidance to providers, pharmacies, and members. You will work in a fast-paced, collaborative clinical team, applying evidence-based guidelines...Remote work
- Mercor is seeking licensed US Pharmacists to support AI-powered prior authorisation workflows by answering medication-related clinical questions and reviewing AI-generated responses for accuracy and safety. This fully remote role requires 30-40 hours per week and independent...Remote jobFor contractors
- Navitus Health Solutions is seeking a Pharmacist I, Clinical Prior Authorization to perform prior authorizations, drug utilization reviews, and support clinical calls requiring pharmacist intervention. You will interface with physicians, pharmacists, and specialty providers...Remote job
- Navitus Health Solutions is hiring a Pharmacist I, Clinical Prior Authorization to perform Prior Authorizations and Drug Utilization Reviews. You will interface with physicians and pharmacists... ...program development. This role may be remote across the United States. #J-18808-...Remote job
- ACTalent is seeking a Pharmacist for a remote Coverage Review role in Tennessee, with the candidate expected to review prior authorizations, pharmacy appeals and member grievances, ensuring... ...), a minimum of 3 years of clinical pharmacy experience or residency/board...Remote jobContract work
- Navitus Health Solutions is seeking a Pharmacist I, Clinical Prior Authorization to manage Prior Authorizations, Drug Utilization Review, and formulary decisions. You will interface with physicians, pharmacists, and specialty providers to optimize beneficiary benefits...Remote job
- Navitus Health Solutions is seeking a Pharmacist I, Clinical Prior Authorization to join our team. You will perform prior authorizations, participate in drug utilization review, and support customer care with pharmacist-intervention calls, interfacing with physicians,...Remote job
$67.48 per hour
Actalent is seeking a Pharmacist for a remote coverage review contract in Tennessee. The role reviews prior authorizations, appeals, and member grievances with compliance to regulations. It requires strong clinical judgment and independent work capability. The position...Remote jobHourly payContract workMonday to Friday- ...cycle, our scalable solutions and clinical expertise help solve programmatic... ...Clinical Quality ReviewerLocation: Remote (Within US Only)Required Schedule:... ...work West Coast HoursThe Clinical Reviewer supports the WISeR Prior Authorization Program by performing comprehensive...Remote workWork at officeImmediate startMonday to Friday
$130k - $160k
...disease areas depending on clinic needs. Work with... ...of pharmacy by reviewing literature, attending... ...access by assisting with prior authorizations, drug therapy appeals... ...medication needs or, Clinical Pharmacist hospital practice... ...30-160K annually. Remote Type Hybrid Work...Remote workFull timeWork at officeImmediate startWork from homeFlexible hoursShift work2 days per week1 day per week$67.48 per hour
Pharmacist - Coverage Review (Remote) Location: Remote (Must reside within 2 hours of Chattanooga, TN)... ...for reviewing medication‑related prior authorizations, pharmacy appeals, and member grievances... ...review experience, strong clinical judgment, and the ability to work...Remote workContract workTemporary workWork at officeWork from homeMonday to Friday- ...Fully remote (never coming onsite) Position Summary The Prior Authorization Pharmacist is responsible for reviewing and evaluating medication prior authorization requests to ensure appropriate... ...effective therapy in accordance with clinical guidelines, regulatory requirements,...Remote workShift work
- Navitus Health Solutions in Phoenix, AZ seeks a Pharmacist I, Clinical Prior Authorization to perform prior authorizations, drug utilization review, and support Customer Care with pharmacist interventions. You will interface with physicians, pharmacists, and specialty providers...Remote job
- ...Authorization Management Clinical Reviewer – Appeals and Denials This job is responsible for reviewing acute and... ...especially in utilization management and prior authorization processes.... ...extended periods of time. #LI-PG1 #LI-Remote WellSky is where independent...Remote workFull timeWork experience placementWork at office
$110k - $150k
...We are seeking a Clinical Pharmacist to join a patient focused pharmacy... ...verify prescriptions, review medication therapy, and counsel... ...on site work with regular remote work. This opportunity... ...Assist patients with prior authorizations, insurance coverage questions...Remote workHourly payFull timeLocal areaMonday to FridayShift work$50 - $52 per hour
...Claims Clinical Documentation Reviewer Schedule: 5-10 hours per week. Resource can... ...weekends if they prefer. Remote position. Equipment is provided... .... Knowledge Service Authorization concepts, principles, and... ...and implementation, prior authorization functions and...Remote workPart timeWork at officeLong distance10 hours per week$59.01k - $81.52k
...through technology, services, and clinical expertise. Our mission is to... ...is looking for a Clinical Reviewer to join our growing team.... ...requirements. Completes prior authorization, continued stay, and retroactive... ...Rules. This is a fully remote position where you must...Remote workFull timeContract workWork at officeLocal areaFlexible hours
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