Pharmacist

Prior Authorization Pharmacist

100% Remote | TN License Required | Entry-Level

This position involves reviewing Utilization Management requests such as formulary exceptions, prior authorizations, step therapy, and quantity limit exceptions for commercial members. The role requires detailed clinical evaluation based on client-specific criteria to approve or deny requests, providing clinical judgment and effective communication.

Responsibilities

• Conduct clinical evaluations for coverage determination requests, including PA or other UM programs like quantity limits, step therapy, formulary exceptions, and tier exceptions.
• Consult directly with healthcare providers or members about non-formulary and clinical product coverage issues.
• Collaborate with team members to ensure consistency in decision-making across the pharmacist team.
• Participate in routine and structured touchpoints with management and team members.
• Complete cases efficiently, maintaining a quality score of 95% or higher.
• Demonstrate a strong attendance record and excellent communication skills.

Requirements

• Doctor of Pharmacy (PharmD) or Bachelor of Science in Pharmacy.
• Current Tennessee pharmacist license in good standing with the State Board of Pharmacy.
• Ability to prioritize tasks and manage multiple projects.
• Ability to make independent clinical decisions.

Additional Skills & Qualifications

• Proficient in learning new computer systems, basic IT troubleshooting, and using multiple monitors.
• Experience with Word and Excel.
• Ability to type 45+ WPM.
• Experience with Pharmacy Benefits Management is a plus but not required.

Job Type & Location

This is a Contract to Hire position based out of Knoxville, TN.

Pay and Benefits

The pay range for this position is $55.00 - $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).

Workplace Type

This is a fully remote position.

Application Deadline

This position is anticipated to close on Sep 14, 2026.