Pharmacist in Boston, MA

Job Description

Job Description

This opportunity is for a Remote Pharmacist focusing on Part B drug and biologic prior authorization reviews within a utilization management setting. The role supports Medicare requirements and internal teams by applying clinical policies and utilization management criteria to authorization decisions. The position requires adaptability in a fast-paced, evolving environment and a commitment to maintaining quality and productivity through changing priorities and volumes.

Key Responsibilities:

• Review and make decisions on Part B drug and biologic prior authorization requests and appeals.
• Apply clinical and Medicare policies to ensure accurate and compliant utilization management.
• Assist clinical and non-clinical teams with inquiries related to Part B drug policies and workflows.
• Identify and recommend improvements for review quality, accuracy, and operational processes.
• Manage workload effectively in a high-volume, dynamic setting with mandatory weekend and holiday rotations.

Qualifications:

• PharmD degree with an active pharmacist license in at least one state.
• Minimum of 2 years’ experience in utilization management, a managed care residency, or relevant specialty pharmacy practice.
• Demonstrated strong clinical judgment in evaluating complex Part B drug requests.
• Experience with Part B drug prior authorization and appeals reviews.
• Prior utilization management and prior authorization experience highly preferred.

Schedule:

• Monday to Friday, 12:00 PM – 8:30 PM EST
• Mandatory weekend and holiday rotations
• No days off except emergencies during contract period

Contract Duration:

• October 1, 2026, through March 31, 2027 (6-month contract)
• Temp to hire opportunity

This position welcomes candidates licensed in any U.S. state and offers the flexibility to work remotely. Candidates with direct Medicare Part B, utilization management, or prior authorization experience will be prioritized.

Take the next step in your career by applying today to contribute your expertise in pharmacy utilization management within a supportive remote work environment.

Compensation for this position ranges from $55.00 to $65.00. Eligible candidates may also receive healthcare benefits, housing, and meals/incidentals. Full details of our healthcare benefits plan can be found here. This posting is open for 60 days after the posting date.

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