Remote Appeals Pharmacist - Prior Authorization & Coverage
$120k - $135kCapital Rx
Judi Health in the United States is seeking a Pharmacist to review clinical coverage determinations and appeals across Commercial and Medicare lines. You will assess medical necessity and use guidelines to render decisions.
The role requires a licensed pharmacist, at least 1 year of appeals experience, and strong communication. Remote work from a secure home office is supported; salary range is $120,000–$135,000 USD.
#J-18808-Ljbffr- ...Insight Global is seeking a licensed Pharmacist to review Prior Authorization and Appeals requests, assess clinical information, and determine coverage in collaboration with physicians and healthcare teams. This remote, fast-paced position requires a PharmD or equivalent...Remote workContract work
- ...UnitedHealth Group is seeking a Pharmacist PA/Appeals to support clinical review and determinations for prior authorization and appeals from a remote role based in Maine or Vermont. The position... ...framework, fulfilling shift coverage from 8:00 AM to 8:00 PM with on-call...Remote workShift work
$40.87 - $80.43 per hour
...Pharmacist Position At UnitedHealthcare, we're simplifying... ...flexibility to work remotely from anywhere within... ...clinical status for appeals requests Conduct... ...appeals of pharmacy coverage decisions Gather... ...Coverage Determinations (prior authorization) or member appeals...Remote jobHourly payWork experience placement- ...Oscar is hiring a Clinical Pharmacist Supervisor - Prior Authorization to join our Pharmacy Utilization Management... ...reviews for prior authorizations and appeals, driving operational excellence,... ...clinical decision-making. This fully remote position is open to candidates...Remote work
- ...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...Remote work
$44 - $79 per hour
.... Join us to start Caring. Connecting. Growing togetherAs a Prior Authorization Pharmacist, you will support clinical review, decisioning, and communication related to pharmacy prior authorization and appeals requests. This role requires strong clinical judgment, attention...Remote workHourly payMinimum wageFull timeTemporary workWork experience placementLocal areaMonday to FridayFlexible hoursShift work$128k - $160k
...Supervisor, Appeals Pharmacist Charlotte, North Carolina, United States; Denver, Colorado... ...Acts as subject matter expert on prior authorization and appeals operations that are compliant... ...+ 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... ...a fully remote Appeals Pharmacist role. Review medication coverage appeals, apply evidence-based guidelines, and ensure fair...Remote workWork from home
- ...Doctorate of Pharmacy ~ Active Pharmacist license in the state of... ...~ Comfortable working remotely and independently in a fast... ...The Role: Review Prior Authorization & Appeals requests, assess clinical... ...information, make evidence-based coverage determinations, and...Remote workContract work
- ...Pharmacist, Prior Authorization (PA) & Appeals Required Skills & Experience: Bachelors or Doctorate of Pharmacy... ...perform responsibilities and duties remotely with little to no supervision... ...and appeals requests to determine coverage based on clinical guidelines, pharmacy...Remote work
- ...The Clinical Pharmacy Reviewer (Pharmacist) evaluates complex prior authorization requests, appeals, and medication coverage determinations to ensure clinical appropriateness and... ...Why Join Dane Street? Collaborative remote culture Professional growth opportunities...Remote workLocal areaWork from home
- ...Supporting Medicare Part D members, the full-time remote Clinical Pharmacist I will manage prior authorization and coverage determination reviews, conduct Medication... ...by reviewing and rendering determinations and appeals Deliver Medication Therapy Management services...Remote workFull timeMonday to Friday
$53.28 - $67.93 per hour
...offering outstanding coverage to our members, compassionate... ...and dedicated pharmacist to join our clinical... ...to focus on the vital prior authorization functions of our work... ...and completing appeal requests, using your... ...required to support remote or hybrid work. Must...Remote workHourly payFull timeTemporary workWork at officeWork from homeShift workAfternoon shift$50 - $55 per hour
Actively Screening for multiple Remote - Pharmacists to join leading pharmacy benefits optimizer... ...Clinical Pharmacist supports the review of prior authorization and appeal requests by evaluating clinical documentation and making coverage determinations based on established...Remote workContract workTemporary workWork from home- ...Per Diem Pharmacist EmpiRx Health is the leading clinically-driven... ...ensures clinical prior authorization and appeal determinations are completed... ...environment. Work Environment: Remote - Ability to work up to 25... ...including Dental & Vision coverage, Health Savings Account,...Remote workDaily paidWork at office
- ...resources when rendering coverage determinations (approvals,... ...thorough documentation in prior authorization cases, appeals cases, and overrides Make... ...requests requiring pharmacist intervention Works to promote... ...disrupt conversations (for remote employees) Familiarity...Remote workWork at officeFlexible hours
$17 - $19 per hour
...Specialist Location: Newark, NJ (Remote) Duration: 6+ Months (... ...and written requests for prior authorization from pharmacists, physicians and/or... ...holders for eligibility, coverage determination claims issues... ...generic dispensing. Process appeals complaints executive inquiries...Remote jobHourly payFull timeTemporary workWork at office- ...be Doctor of Pharmacy *Must have PBM/Prior Authorization experience *Must be willing to work... ...render decisions on authorizations and appeals for pharmacy drug requests • Conduct... ...3+ years of experience as a licensed pharmacist • Active, unrestricted pharmacist license...Remote workHourly payContract workShift workWeekend work
- ...Clinical Pharmacist, Coverage Determination The Coverage Determination Pharmacist will provide... ...Coverage Determination reviews (prior authorizations, formulary exceptions, etc.) for both... ...exception requests, complaints, and appeals, and ensure criteria and decisions...Immediate startFlexible hours
- ...A-Line Staffing Solutions is actively hiring licensed Pharmacists for remote Prior Authorization roles with multiple start dates and scheduling options... ...authorization requests, applying clinical judgment to coverage criteria, communicating with prescribers, ensuring regulatory...Remote workFull timeWork from homeFlexible hours
- ...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...Remote workWork from home
$113.33k - $170k
...Alignment Health is seeking a Clinical Pharmacist I to join the pharmacy Team. A Clinical Pharmacist I is a remote, full-production managed care... ...position primarily supports Part D prior authorization and coverage determination / appeal reviews, along with Medication...Remote workFull timeMonday to FridayShift workWeekend work- ...Position Title: Pharmacist Location: Remote EST Duration: 3 Months Schedule: Mon Fri... ...healthcare professional employed in the Prior Authorization Department the primary... ...prior authorization requests for coverage of pharmaceutical products. Determinations...Remote work
$18 - $32 per hour
Realistic Job Preview Video Remote in Alabama, Arizona,... ...a Senior Pharmacy PA/Appeals Technician include supporting the prior authorization and appeals process by... ...members, providers, pharmacists, and internal business... ...Long-Term Disability coverage 401(k) Savings Plan, Employee...Remote workHourly payMinimum wageFull timeTemporary workWork experience placementLocal areaFlexible hoursShift work- ...pharmacy, the full-time Texas Licensed Prior Authorization Pharmacist will perform comprehensive clinical... ...manage prior authorization requests remotely, ensuring timely approvals and... ...specific medical necessity criteria and coverage policies Communicate directly with...Remote workFull time
$130k
...Utilization Management Pharmacist (temp-to-hire) Remote About Judi Health Judi Health is a health... ...is responsible for reviewing prior authorization requests, supporting clinical programs... ...on prior authorizations, appeals, and override requests using clinical...Remote workTemporary workLocal areaFlexible hoursShift workWeekend work$30 - $53 per hour
...Remote Prior Authorization Pharmacist Opportunities available for you! These are great Remote Pharmacist roles in which you will get the chance to... ...clinical judgment and pharmaceutical knowledge to determine coverage based on clinical guidelines and plan criteria...Remote workHourly payFull timeLocal areaAll shiftsMonday to Friday$53 per hour
...We are seeking a qualified Pharmacist for a fully remote opportunity supporting a leading healthcare organization. The successful... ...AM–8:00 PM Job Duties: Evaluate and review all prior authorization requests and render coverage determinations based on clinical criteria and...Remote workFull timeHome officeShift work- ...Actalent is actively screening for multiple remote Pharmacists to join a leading pharmacy benefits optimizer based out of Birmingham, AL. The Clinical Pharmacist reviews prior authorization and appeals, collaborates with prescribers and pharmacies, and ensures regulatory...Remote work
- ...their time zone starting 100% remote. Duties: Utilization management pharmacists are responsible for reviewing... ...plans policy to determine if coverage can be granted for a medication... ...finalizing all denials of clinical prior authorization requests. Skills:...Remote workShift work
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