Pharmacist | Waltham, Massachusetts

Job Description

Job Description

A remote pharmacist opportunity is available supporting Part B drug and biologic prior authorization requests and appeals. This temp-to-hire role requires expertise in clinical policy application, utilization management, and Medicare requirements to make informed authorization decisions. The position demands adaptability in a fast-paced environment with evolving workflows, while maintaining high-quality review accuracy and productivity.

Key Responsibilities:

• Review and evaluate Part B drug and biologic prior authorizations and appeals.
• Apply clinical policies, utilization management criteria, and Medicare guidelines to authorization decisions.
• Provide support to internal clinical and non-clinical teams regarding Part B drug policies and workflows.
• Identify and recommend process improvements to enhance review quality and operational efficiency.
• Manage workload while adapting to changing priorities and volumes.

Qualifications and Experience:

• PharmD degree with an active pharmacist license in at least one state.
• Minimum 2 years of experience in utilization management, managed care residency, or specialty pharmacy.
• Demonstrated strong clinical judgment with the ability to independently assess complex Part B drug requests.
• Experience in Part B drug prior authorization and/or appeals review strongly preferred.
• Background in Medicare Part B, utilization management, and prior authorization is highly valuable.

Location & Schedule:

• Fully remote position, open to licensed pharmacists from any state.
• Monday to Friday, 12:00 PM – 8:30 PM EST.
• Mandatory weekend and holiday rotation.
• Contract duration: October 1, 2026, to March 31, 2027.

Additional Details:

• All necessary equipment will be provided.
• This is a 6-month contract with temp-to-hire potential.

Interested candidates with the required expertise who thrive in dynamic, clinical utilization roles are encouraged to apply for this specialized pharmacist position supporting Medicare Part B pharmacy services.

Compensation for this position ranges from $52.00 to $72.00. 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.

#p31