Remote Prior Authorization Clinical Pharmacist (PBM)
The Elevance Health Companies, Inc.
Elevance Health is hiring a Prior Authorization Clinical Pharmacist for a virtual role with required in-person training. The position supports DUR, DIS, and formulary management and requires a valid pharmacist license in the applicable state(s). A strong background in PBM and clinical pharmacology is preferred.
Location options include remote with occasional on-site requirements in designated locations. The role emphasizes heavy collaboration with network physicians and clinical teams, with a
#J-18808-Ljbffr$45 - $55 per hour
...Bring your expertise as a Clinical Pharmacist to an organization where your... ...medications by reviewing prior authorizations and supporting coverage determinations... .... Benefits & Extras: Fully remote opportunity with... ...incoverage determination and PBM systems Compensation: $45–$...Remote workWeekend work- ...WellSense Health Plan is seeking a Clinical Pharmacist I to lead pharmacy utilization management and support PBM coordination and formulary... ...role includes reviewing prior authorization, ensuring compliance with... ...are required. This is a remote, full-time opportunity with...Remote workFull time
- ...Health Solutions, LLC is seeking a Pharmacist, Population Health to support Navitus Clinical Programs, including Drug... ...ensuring cost-effective, evidence-based PBM programs while adhering to Medicare... ...Part D, PQA, and HEDIS guidelines. Remote, nationwide. #J-18808-LjbffrRemote work
- ...To support clinical programs, the full-time remote State Licensed Clinical Pharmacist will perform Prior Authorizations, conduct Drug Utilization Reviews, and assist Customer Care with clinical... ...practice residency Knowledge of the PBM industry, formulary management, and...Remote workFull timeWork experience placement
$150k - $155k
...Overview Clinical Pharmacist - VytlOne Specialty-Remote VytlOne is currently seeking an experienced Clinical Pharmacist... ...and appropriateness, supports prior authorization and utilization review activities... .... By uniquely combining PBM and Pharmacy Services into one integrated...Remote workTemporary workWork at office- ...The Clinical Pharmacy Reviewer (Pharmacist) evaluates complex prior authorization requests, appeals, and medication coverage determinations... ...review experience within a PBM environment. Preferred... ...Dane Street? Collaborative remote culture Professional growth...Remote workLocal areaWork from home
- ...Clinical Pharmacist (Prior Authorization) Immediate need for a talented Clinical Pharmacist (Prior Authorization... ...potential and is located in U.S (Remote). Please review the job description... ...retail, hospital, managed care, or PBM settings, with prior authorization review...Remote workContract workImmediate start
- ...Clinical Quality Pharmacist The Clinical Quality Pharmacist is responsible for... ...clinical audits of Prior Authorization (PA) and Appeals staff and... ...experience in managed care, PBM, or health plan setting in... ...company location (or from a remote location with management approval...Remote workWork experience placementWork at officeLocal areaMonday to FridayNight shiftWeekend work
$60 per hour
Now Hiring: Clinical Pharmacist (Remote) Join Oscar Health and play a key role in supporting evidence... ...What You'll Do Review and evaluate prior authorization requests and appeals Apply clinical... ...clinical review experience Managed Care, PBM, Health Plan, or Insurance...Remote jobContract workImmediate startShift workWeekend work- ...A healthcare staffing agency is seeking a PBM/Prior Authorization Review Pharmacist for a remote position. The role entails reviewing prior authorization requests... ...compliance with regulations, and supporting clinical programs. Ideal candidates will have a pharmacy degree...Remote workContract work
- ...A healthcare staffing firm is seeking a Remote Clinical Pharmacist with prior authorization experience to join their team. The role involves evaluating and reviewing prior authorization requests, consulting with healthcare providers, and ensuring timely communication of...Remote work
- ...Motion Recruitment is seeking a Clinical Pharmacist for a remote position with a nationally recognized health insurance client. The role centers on prior authorization reviews, clinical guidance, and ensuring compliant pharmacy practices. You will review authorization...Remote work
$107.7k - $199.3k
...MarketplaceKey Details: This is a fully remote position. Candidates... ...abuse reporting • Develop clinical criteria for review of non-... ...guideline criteria for prior authorization and non-formulary drugs in... ...Certifications: Current state’s Pharmacist license with no...Remote workFull timePart timeWork at officeFlexible hours$122k - $128k
Clinical PharmacistJob Purpose:Provide integrated support to patients... ...clinical data needed for prior authorization approvals and development... ...limited to comprehensive pharmacist consultation, motivational... ...current registration and all remote pharmacist activity to...Remote workWork at officeLocal area- ...DescriptionUse Your Strengths as an Associate Clinical Pharmacist at Wellmark!In this role, you'll... ...of formularies and evidence-based prior authorization criteria, performing drug utilization... ...office, with 2 days (Monday, Friday) remote option. QualificationsRequired...Remote workPermanent employmentWork experience placementInternshipH1bWork at officeMonday to Friday
- ...Actalent is seeking a fully remote Clinical Pharmacist focused on utilization management for specialty medications, with emphasis on oncology... ...therapies. You will review coverage determinations, prior authorizations, formulary exceptions, and step therapy across...Remote work
$60 per hour
...Oscar Health is seeking a Clinical Pharmacist to work remotely. The role supports evidence-based medication coverage decisions from home. You will review prior authorization requests, apply clinical criteria, and engage with prescribing physicians to ensure appropriate...Remote workContract workWork from homeShift workWeekend work$55.28 - $57.69 per hour
...post-acute care. What you will do Provide clinical review and consultation on medication requests, prior authorizations, and benefit determinations. Evaluate... ...preferred ~ Full, current, and unrestricted pharmacist license in PA, TN ~ Ability to obtain additional...Remote workRelocation packageShift work$127k - $133k
...We’re hiring an Ambulatory Clinical Pharmacy Specialist who will... ...$10,000.00 Location: Remote Salary: An employee in... ...The Ambulatory Clinical Pharmacist (ACP) will help advance quality... ...roles handling complex prior authorizations/appeals by providing clinical...Remote workHourly payFull timeWork at officeLocal areaRelocation package- ...UNITAS provides clinical staffing and consulting solutions, including... ...The Utilization Management Pharmacist plays a vital role in... ...is responsible for reviewing prior authorization requests, supporting clinical... ...pharmacy benefit management (PBM) We provide equal employment...Remote workPermanent employmentContract workLocal areaWeekend work
- Purpose: Remote Clinical Pharmacists play a critical role in optimizing medication therapy, providing clinical support, and ensuring seamless... ...programs to facilitate medication access. Support prior authorization processes and assist in navigating insurance barriers...Remote workWork at officeHome office
- ...Clinical PharmacistImmediate need for a talented Clinical Pharmacist. This is a 06+months contract opportunity with long-term potential and is located in U.S(Remote).Key Responsibilities:Review prior authorization requests and make determinations for drug products according...Remote workContract workLocal areaImmediate start
$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$60 - $65 per hour
...Job Title: 100% Remote Pharmacist The Pharmacist performs comprehensive final prior authorization reviews and ensures safe, compliant medication use in accordance with all... ...federal regulations. This role focuses on clinical and regulatory accuracy, supports medication...Remote workContract workTemporary workHome officeMonday to FridayShift work- ...role at a glance Location: Remote Department: Ascension... ...this role Provide advanced clinical pharmacy care including... ...interprofessional teams to streamline prior authorizations, medication delivery... ...Required Credential(s): Pharmacist obtained prior to hire date...Remote workFull timeWork experience placementLocal areaMonday to FridayDay shift
- ...Oscar Health is seeking a Clinical Pharmacist Supervisor - Prior Authorization to lead the Pharmacy Utilization Management team. You will oversee clinical reviews... ..., evidence-based decisions. The role is fully remote in the United States (excluding certain states) and...Remote work
- ...Oscar Health seeks a Clinical Pharmacist Supervisor - Prior Authorization to lead a team of pharmacists performing clinical reviews for prior authorizations... ...the Manager, Pharmacy Utilization Management and work remotely from the U.S. with occasional travel for meetings...Remote work
$70 per hour
...Clinical Pharmacist Make an impact in healthcare from the comfort of your home. We're seeking a detail... ...and supporting quality pharmacy care through prior authorization reviews and clinical decision-making. Location: Remote (North Carolina Resident Required) Pay Rate...Remote workTemporary workWork from homeMonday to FridayDay shift$130k - $160k
...disease areas depending on clinic needs. Work with patients, providers... ...access by assisting with prior authorizations, drug therapy appeals,... ...medication needs or, Clinical Pharmacist hospital practice experience... ...in $130-160K annually. Remote Type Hybrid Work...Remote workFull timeWork at officeImmediate startWork from homeFlexible hoursShift work2 days per week1 day per week- ...Clinical Pharmacist Dothouse Health is a diverse, multi-disciplinary health care and social... ...continuous glucose monitoring (CGM) and remote blood pressure monitoring, and... ...medication access by assisting with complex prior authorizations, formulary restrictions, medication...Remote workFull time
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