Pharmacist

Clinical Pharmacist

The Clinical Pharmacist supports the review of prior authorization and appeal requests by evaluating clinical documentation and making coverage determinations based on established criteria. This role involves collaborating with prescribers, pharmacies, and internal teams to obtain necessary clinical information, document decisions, and communicate outcomes. The pharmacist ensures reviews are completed accurately, efficiently, and in compliance with applicable regulatory and client requirements while contributing to process improvements within the prior authorization program.

Experience working with multiple PBM platforms and payer-specific prior authorization workflows

Familiarity with medical benefit vs. pharmacy benefit coverage determinations

Exposure to appeals processing (first-level, second-level, or external review submissions)

Working knowledge of managed care, utilization management, or health plan operations

Experience communicating clinical rationale to providers, pharmacies, or members in written or verbal form

Comfort reviewing specialty medications (e.g., biologics, oncology, immunology, rare disease)

Understanding of CMS, state-level, and payer regulatory requirements related to prior authorization

Experience using workflow, ticketing, or case management systems for clinical reviews

Ability to identify process inefficiencies and contribute to workflow or policy improvements

Experience supporting high-volume or metrics-driven environments while maintaining quality standards

This is a Contract position based out of Birmingham, AL.

The pay range for this position is $50.00 - $55.00/hr. Individual compensation offered for this position within this range will depend on many factors, including qualifications, skills, relevant experience, job knowledge, geographic location, internal equity, and other pertinent job-related factors.

Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: • Medical, dental & vision • Critical Illness, Accident, and Hospital • 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available • Life Insurance (Voluntary Life & AD&D for the employee and dependents) • Short and long-term disability • Health Spending Account (HSA) • Transportation benefits • Employee Assistance Program • Time Off/Leave (PTO, Vacation or Sick Leave)

This is a fully remote position.

This position is anticipated to close on Sep 22, 2026.