Pharmacy PA Specialist - Expert
$75 per hourMercor
Job Description
Job Description
About the job
Mercor connects elite creative and technical talent with leading AI research labs. Headquartered in San Francisco, our investors include Benchmark , General Catalyst , Peter Thiel , Adam D'Angelo , Larry Summers , and Jack Dorsey .
Position: Pharmacy Prior Authorization & Specialty-Medication Access Specialist
Type: Contract
Compensation: $75/hour
Location: Remote
Role Responsibilities
- Process and manage prior authorisation requests for speciality medications, biologics, and high-cost pharmaceuticals across commercial, Medicare Part D , and Medicaid payers.
- Review clinical documentation and pharmacy benefit criteria to determine medical necessity for speciality drug authorisations.
- Evaluate AI-generated pharmacy prior authorisation recommendations for accuracy, completeness, and payer compliance.
- Coordinate with prescribers, speciality pharmacies, and payers to obtain timely medication authorisations.
- Manage appeals for denied pharmacy authorisations, including peer-to-peer requests and exception processes.
- Annotate AI outputs and provide structured feedback to support AI training datasets .
Qualifications
Must-Have
- 5+ years of experience in pharmacy prior authorisation, speciality medication access, or pharmacy benefit management.
- Deep knowledge of speciality drug formularies, step therapy protocols, and payer PA criteria across commercial and government payers.
- Experience with speciality pharmacy platforms and pharmacy benefit management ( PBM ) systems.
- Familiarity with Medicare Part D coverage determination and exception processes.
- Exceptional written and verbal English communication skills.
- High attention to detail with the ability to evaluate clinical documentation and AI-generated outputs.
Preferred
- Certified Pharmacy Technician (CPhT) or Certified Prior Authorisation Professional (CPAP) credential.
- Experience with hub services and patient assistance programs for speciality medications.
- Background in speciality pharmacy, infusion services, or oncology/rheumatology drug access.
- Familiarity with AI tools and comfort evaluating AI-generated pharmacy content.
- Experience with manufacturer copay assistance and patient access programs.
Application Process (Takes 20–30 mins to complete)
- Upload resume
- AI interview based on your resume
- Submit form
Resources & Support
- For details about the interview process and platform information, please check:
- For any help or support, reach out to: View email address on ziprecruiter.com
PS: Our team reviews applications daily. Please complete your AI interview and application steps to be considered for this opportunity.
Vacancy posted 3 days ago
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