Sign up to access all features of our service.
  • Job search
  • Favorites
  • Create a CV
    New
  • Salaries
  • Subscriptions

Remote Coverage Review Pharmacist Appeals & Compliance

Global Channel Management

A healthcare management company is seeking a Remote Coverage Review Pharmacist located in Tennessee. This role requires a Doctor of Pharmacy (PharmD) degree, clinical experience, and a solid understanding of regulatory guidelines. The Pharmacist will be responsible for reviewing medication-related prior authorizations, appeals, and grievances, working independently or in a team to deliver quality pharmaceutical services. Excellent communication and organizational skills are essential for this position. #J-18808-Ljbffr

Vacancy posted 2 days ago
Similar jobs that could be interesting for youBased on the Remote Coverage Review Pharmacist Appeals & Compliance in Chattanooga, TN vacancy
  • 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 job
    Work from home

    Pharmacy Careers

    Seattle, WA
    4 days ago
  • 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...  ...that decision letters meet regulatory compliance #J-18808-Ljbffr... 
    Remote job
    Work at office

    Globalchannelmanagement

    Chattanooga, TN
    2 days ago
  •  ...Remote Appeals Pharmacist - Fair Medication Access | Work From Home | Strong Clinical Writing...  ...fully remote Appeals Pharmacist role. Review medication coverage appeals, apply evidence-based...  ...and report appeal outcomes in full compliance with state and federal rules.... 
    Remote work
    Work from home

    Pharmacy Careers

    United States
    3 days ago
  • WPS Health Solutions is hiring an Appeals Nurse to review medical records and claims for first-level Medicare appeal cases to determine medical necessity and compliance with coverage guidelines. The role collaborates with Appeals Examiners to ensure timely redeterminations... 
    Remote job

    WPS—A health solutions company

    New York, NY
    3 days ago
  • 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 job
    Work from home

    Pharmacy Careers

    Arlington, VA
    4 days ago
  • 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 job
    Work from home

    Pharmacy Careers

    Kansas City, MO
    4 days ago
  • $44 - $79 per hour

     ...Pharmacist At UnitedHealthcare, we're simplifying the health care...  ...interactions, and clinical status for appeals requests Conduct Quality...  ...within area of expertise Review formulary and utilization...  ...provider appeals of pharmacy coverage decisions Gather complex... 
    Remote work
    Hourly pay
    Minimum wage
    Full time
    Work experience placement
    Local area
    Monday to Friday

    UMR

    United States
    2 days ago
  • Pharmacy Careers is seeking a Remote Drug Utilization Review (DUR) Pharmacist to analyze medication use patterns, apply clinical guidelines, and collaborate...  ...for prescribers to optimize therapy while ensuring compliance with state and health-plan requirements. #J-18808-... 
    Remote job

    Pharmacy Careers

    Fontana, CA
    4 days ago
  • Pharmacy Careers is seeking a Remote Appeals Pharmacist focused on fair medication access. This...  ...remote or hybrid role involves reviewing medication coverage appeals, applying evidence-based...  ...medical directors, ensure regulatory compliance, and help advance appeals and... 
    Remote job

    Pharmacy Careers

    Newark, NJ
    4 days ago
  • $40.87 - $80.43 per hour

     ...Pharmacist At UnitedHealthcare, we're simplifying the...  ...flexibility to work remotely* from anywhere within...  ...and clinical status for appeals requests Conduct Quality...  ...area of expertise Review formulary and...  ...provider appeals of pharmacy coverage decisions Gather... 
    Remote job
    Hourly pay
    Work experience placement

    Phenom People

    Minnetonka, MN
    5 days ago
  • $70 per hour

     ...PharmD USA, LLC is a leading provider of remote and on-site clinical pharmacy...  ...nationwide. Our team of experienced pharmacists provides comprehensive medication management, regulatory compliance support, and clinical chart reviews to ensure patient safety and quality... 
    Remote work
    Hourly pay
    Daily paid
    Part time
    Local area
    Flexible hours

    PharmD USA

    Chico, CA
    12 days ago
  • $123.5k

     ...seeking a Clinical Nuclear Pharmacist to join the Nuclear...  ..., regulatory compliance, and continuous improvement...  ...Employer-paid medical coverage starting day one for employees...  ...and therapeutic use. Review orders for indication,...  ...: Hybrid Onsite/Remote Pivotal Position: Yes... 
    Remote work
    Full time
    Traineeship
    Work experience placement
    Work at office
    Local area
    Relocation package
    Weekend work

    UT MD Anderson

    Houston, TX
    3 days ago
  •  ...Pharmacist, Prior Authorization (PA) & Appeals The pharmacist is responsible for reviewing and evaluating prior authorization and appeals requests to determine coverage based on clinical guidelines, pharmacy policies...  ..., and ensure compliance with federal and state... 
    Remote work

    Insight Global

    United States
    2 days ago
  •  ...Remote, AZ Contract Job Title: Pharmacist Location: Remote Duration: 12+ months contract Job Description...  ...set up for our members, review clinical information for decisioning...  ...all Medicare Part D requests, in compliance with Medicare guidelines, while promoting... 
    Remote work
    Contract work

    US Tech Solutions

    United States
    1 day ago
  •  ...Description The Pharmacist, Prior Authorization (PA) & Appeals, is responsible for reviewing and evaluating prior...  ...requests to determine coverage based on clinical...  ...alternatives, and ensure compliance with federal and...  ...responsibilities and duties remotely with little to no... 
    Remote work

    Insight Global

    United States
    58 minutes ago
  • Pharmacy Careers is seeking a Remote Prior Authorization Pharmacist to review medication requests from home, applying evidence-based criteria to determine medical necessity and plan compliance. Ideal candidates hold a PharmD or Bachelor of Pharmacy, with an active U.S.... 
    Remote job
    Work from home
    Flexible hours

    Pharmacy Careers

    Arlington, VA
    4 days ago
  • WPS Health Solutions is seeking an Appeals Nurse to review medical records and claims for first-level Medicare redeterminations to determine medical necessity and coverage alignment. You will collaborate with Appeals Examiners/Reps to ensure timely, accurate determinations... 
    Remote job

    WPS—A health solutions company

    Brooklyn, NY
    3 days ago
  •  ...Solutions in Columbus, OH, is seeking an Appeals Nurse to review medical records and Medicare claims...  ...to determine medical necessity and coverage alignment. The role collaborates with...  ...document clinical rationales, and ensure compliance with CMS guidelines. A registered... 
    Remote job

    WPS Health Solutions

    Columbus, OH
    3 days ago
  •  ...healthcare intelligence company. The Medical Review Nurse II audits home health claims, working remotely with a multi-location team to ensure compliance and high-quality documentation. The...  ...guidelines, and participate in the appeals process while staying current with... 
    Remote job
    Work from home

    Machinify

    New York, NY
    5 days ago
  • Remote Prior Authorization Pharmacist - Work From Home | Flexible Schedule | High Clinical Impact Transition...  ...Prior Authorization Pharmacist role. Review medication requests from home,...  ...cost cases. Document all decisions in compliance with CMS, state, and health-plan requirements... 
    Remote job
    Work from home
    Flexible hours
    Afternoon shift

    Pharmacy Careers

    Jackson, MS
    4 days ago
  • $24.79 per hour

     ...Member Appeals Specialist Trillium Professional...  ...Specialist for a 100% remote position! Candidates...  ...pre-service pharmacy coverage for non-Medicare health...  ...resolution while ensuring compliance with regulatory...  ...40 active appeals. Review appeals for timeliness... 
    Remote work
    Work at office
    Monday to Friday

    Trillium Staffing

    United States
    1 day ago
  • Pharmacy Careers is seeking a Remote DUR Pharmacist to analyze medication use patterns, apply clinical guidelines, and collaborate with providers...  ...all from home. This remote role focuses on drug utilization reviews across settings, evaluating prescribing patterns,... 
    Remote job

    Pharmacy Careers

    Santa Monica, CA
    4 days ago
  •  ...Remote Clinical Review Pharmacist - Work From Home | Evidence-Based Decisions | Flexible Schedule Leverage your clinical knowledge in a fully remote Clinical Review Pharmacist role. Evaluate prescriptions and treatment plans for safety, appropriateness, and cost... 
    Remote work
    Work from home
    Flexible hours

    Pharmacy Careers

    United States
    2 days ago
  • Pharmacy Careers is seeking a Remote DUR Pharmacist to analyze medication use patterns from home. You will conduct prospective, concurrent, and retrospective reviews, evaluating prescribing against guidelines and formulary criteria to improve outcomes at scale. The role... 
    Remote job

    Pharmacy Careers

    Lakewood, NJ
    4 days ago
  • 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

    WellDyne

    New York, NY
    4 days ago
  • Pharmacy Careers is seeking a Remote DUR Pharmacist to analyze medication-use patterns from home, apply clinical guidelines, and...  ...interactions, prepare recommendations, and document reviews while ensuring compliance with health-plan requirements. #J-18808-Ljbffr Pharmacy... 
    Remote job

    Pharmacy Careers

    Aurora, CO
    4 days ago
  • Pharmacy Careers is seeking a Remote DUR Pharmacist to analyze medication use patterns from home, applying clinical guidelines to...  ...conduct prospective, concurrent, and retrospective reviews while ensuring compliance with regulatory standards. Ideal candidates hold a PharmD... 
    Remote job

    Pharmacy Careers

    Cleveland, OH
    4 days ago
  • Pharmacy Careers is seeking an MTM Pharmacist to positively impact patient...  ...comprehensive medication reviews, coaching adherence, and...  ..., and ensure CMS MTM program compliance while collaborating with care...  ...Bachelor's degrees are welcome; remote or hybrid roles with competitive... 
    Remote job
    Flexible hours

    Pharmacy Careers

    Wilmington, DE
    4 days ago
  • Pharmacy Careers in the United States is seeking a Remote DUR Pharmacist to analyze medication use patterns from home. You will apply clinical guidelines, review prescribing against formulary criteria, and collaborate with providers to optimize therapy and reduce risk.... 
    Remote job

    Pharmacy Careers

    Manchester, NH
    4 days ago
  • 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 communication with providers, patients, and internal teams. You will work a... 
    Remote job
    Monday to Friday

    Colorado PA

    Houston, TX
    3 days ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Remote Coverage Review Pharmacist Appeals & Compliance. Be the first to apply!