Remote Pharmacist: PA Appeals & Coverage Decisions
UnitedHealthcare
- Remote job
UnitedHealthcare is seeking a pharmacist to evaluate prescriptions, interpret clinical documentation, and provide expert guidance on drug utilization. The role requires a licensed PharmD with at least 1 year of pharmacist experience, strong record-keeping, and proficiency with MS Office. The position offers a Monday–Friday schedule alternating with Tue–Sat every other week, with telecommuting from anywhere in the U.S. #J-18808-Ljbffr UnitedHealthcare
- UnitedHealth Group is seeking a Pharmacist to evaluate prescriptions, analyze patient histories, and render prior authorization decisions. The role supports telecommuting from anywhere in the U.S. with standard pharmacist duties and clear documentation requirements. Required...Remote job
$44 - $79 per hour
...Pharmacist At UnitedHealthcare, we're simplifying the... ...and clinical status for appeals requests Conduct Quality... ...to render appeal decision Provide explanations... ...provider appeals of pharmacy coverage decisions Gather... ...case review & rendering PA decisions ~...Remote workHourly payMinimum wageFull timeWork experience placementLocal areaMonday to Friday- A healthcare management company is seeking a Remote Coverage Review Pharmacist located in Tennessee. This role requires a Doctor of Pharmacy (PharmD... ...responsible for reviewing medication-related prior authorizations, appeals, and grievances, working independently or in a team to...Remote work
- UnitedHealth Group is seeking a Pharmacist to evaluate prescriptions, review clinical data, and render prior authorization decisions. This remote role requires an active state license and strong... ...purchase, and incentive programs are offered. #J-18808-Ljbffr Colorado PARemote jobMonday to Friday
- UnitedHealth Group is seeking a Senior Pharmacy PA/Appeals Technician to support prior authorization and appeals across multiple channels... ...ability to work flexible shifts. You will collaborate with pharmacists and clinicians to resolve complex requests while adhering to...Remote jobFlexible hours
- ...Senior Pharmacy PA/Appeals Technician Optum is a global organization... ...to members, providers, pharmacists, and internal business partners... ...questions or judgment-based decisions to the appropriate... ...disability and Long-Term Disability coverage ~401(k) Savings Plan, Employee...Remote jobTemporary workFlexible hoursShift work
- About the job Remote Coverage Review Pharmacist Remote Coverage Review Pharmacist needs 3 years and Doctor... ...associated with coverage reviews and appeals including the review of medication... ...established time periods Builds and maintains decision trees in the prior authorization...Remote jobWork at office
- UnitedHealth Group is seeking a pharmacist to evaluate prescriptions, assess patient histories, and render timely PA decisions. The role supports appeals, requires strong clinical knowledge, and offers telecommuting from anywhere in the United States. The position emphasizes...Remote job
$55.28 - $57.69 per hour
.... Support complex case reviews and appeals with accurate clinical documentation.... ...preferred ~ Full, current, and unrestricted pharmacist license in PA, TN, and/or OH ~ Ability to obtain... ...are important Every medication decision we make affects someone’s health, safety...Remote workRelocation packageShift work- ...Remote Appeals Pharmacist – Fair Medication Access | Work From Home | Strong Clinical Writing Focus Combine clinical expertise with advocacy... ...a fully remote Appeals Pharmacist role. Review medication coverage appeals, apply evidence-based guidelines, and ensure fair...Remote workWork from home
- Pharmacy Careers is seeking a Remote Appeals Pharmacist to ensure fair access to medications. You will review clinical documentation for coverage appeals from home and provide evidence-based determinations. This role supports managed care through strong documentation, clinical...Remote jobWork from home
$75 per hour
...Compensation: $75/hour Location: Remote Role Responsibilities... ...authorisations. Manage appeals for denied pharmacy... ...therapy protocols, and payer PA criteria across commercial and... ...Familiarity with Medicare Part D coverage determination and exception processes...Remote workContract workSummer work- Pharmacy Careers is seeking a fully remote Appeals Pharmacist to review medication coverage appeals and provide evidence-based determinations from home. A focus on clear clinical writing and regulatory compliance helps ensure fair access for members. The role supports remote...Remote jobWork from home
- Pharmacy Careers is seeking a Remote Appeals Pharmacist to review medication coverage appeals from home, applying evidence-based guidelines and regulatory requirements to reach fair determinations. This role emphasizes strong clinical writing and collaboration with physicians...Remote jobWork from home
- Pharmacy Careers is seeking a Remote Appeals Pharmacist focused on fair medication access. This fully remote or hybrid role involves reviewing medication coverage appeals, applying evidence-based guidelines, and writing clear clinical rationales for determinations. You...Remote job
- ...Description ************FULLY REMOTE******* The Pharmacist, Prior Authorization (PA) & Appeals, is responsible for reviewing and... ...appeals requests to determine coverage based on clinical guidelines, pharmacy... .... Accurately document case decisions in accordance with internal...Remote work
$107k - $127k
...Description Senior Managed Care Pharmacist – Formulary / Pharmacy and Therapeutics Strategy (PA Licensed) Role Type: Full-... ...hours) Work Arrangement: 100% Remote / Work from Home Location:... ...networks with comprehensive medical coverage options for you and your family...Remote workPermanent employmentFull timeContract workWork from homeMonday to FridayShift work- ...Management Clinical Pharmacist, you will join... ...determinations of coverage. In this role, you... ...prior authorization (PA) requests for... ...Evaluate and adjudicate appeal requests for... ...approval and denial decisions clearly, professionally... ...case reviews. Remote Productivity: Self...Remote work
$54 - $91 per hour
Staff Pharmacist, Specialty - Evernorth - Remote - (PA License) Job Summary: This role involves supporting pharmacy operations by understanding billing, reimbursement... ...Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group,...Remote jobHourly payWork at officeLocal areaWork from homeFlexible hoursShift workNight shiftWeekend work- UnitedHealth Group is seeking an experienced Pharmacist to evaluate prescriptions and patient... ...documents, and render prior authorization decisions. You will consult with patients and providers on medication use, coverages, and potential drug interactions, while ensuring...Remote jobHourly pay
- ...Location: On-site - Pittsburgh, PA (but willing to travel to... ...Purpose The Trainer, Fulfillment Pharmacist trains Fulfillment Clinical Pharmacists... ...of the job. Hybrid, remote and flexible on-site work schedules... ...short/long term disability coverage, and an Employee Assistance...Remote workFull timeTemporary workPart timeWork at officeLocal areaFlexible hours
- WellDyne is seeking a remote Prior Authorization Clinical Pharmacist to handle clinical reviews for PA programs, under the direction of the Manager, Clinical Services. This role focuses on retail clients and adherence to regulatory standards. The candidate should be licensed...Remote job
- ...The Ambulatory Clinical Pharmacist will service outpatient... ...role. Location: Hybrid/remote (Pennsylvania) with... ...required in West Reading, PA for training, quarterly... ...authorizations, manage denials/appeals. Demonstrate ability to... ..., infertility coverage, family building support...Remote jobFull timeWork at officeLocal areaWorldwideMonday to Friday
$124.68k - $187.02k
...PharmacistApplyremote type: Remote - Full Timelocations:... ...Summary**The Clinical Pharmacist I supports clinical... ...I makes clinical decisions within defined scope,... ...utilization trends, denial/appeal processes, and... ...criteria and Medicare coverage determinations to ensure...Remote workFull timeTemporary work$3,518 per week
...Pharmacist Location: York, PA Agency: Anders Group Pay: $3,518 per week Shift Information: Days - 5 days x 8 hours Contract... ...Travel reimbursement options ~ Medical, dental, and vision coverage ~401(k) retirement plan ~ Licensure and...Weekly payFull timeContract workLocal areaShift work$3,526 per week
...Pharmacist Location: York, PA Agency: Cynet Health Pay: $3,526 per week Shift Information: Days - 5 days x 8 hours Contract... ...with guidelines, the candidate will be sent for a final decision. Minimum experience of 2 years is required. Candidates...Full timeContract workShift work$3,840 per week
...Pharmacist Location: York, PA Agency: Seven Healthcare Pay: $3,840 per week Shift Information: Days - 5 days x 8 hours Start... ...Health insurance - comprehensive medical coverage for you and your family Certification reimbursement...Weekly payFull timeContract workImmediate startFlexible hoursShift work- ...Pharmacist Location: York, PA Agency: Concentric Healthcare Staffing Pay: Competitive weekly pay (inquire for details) Shift Information... ...documentation Participate in rotating Saturday coverage and holiday coverage as needed May float to a nearby...Weekly payFull timeContract workImmediate startShift workWeekend workDay shift
$3,715 per week
...Pharmacist Location: York, PA Agency: Seven Healthcare Pay: $3,715 per week Shift Information: Days - 5 days x 8 hours Start... ...Health insurance - comprehensive medical coverage for you and your family Certification reimbursement...Weekly payFull timeImmediate startFlexible hoursShift work$2,914 per week
...Pharmacist Location: Horsham, PA Agency: Seven Healthcare Pay: $2,914 per week Shift Information: 8 hours Start Date: ASAP... ...professionals Health insurance - comprehensive medical coverage for you and your family Certification reimbursement...Weekly payFull timeContract workLocal areaImmediate startFlexible hoursShift workWeekend work
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