Remote Clinical Review Pharmacist

Prior Authorization Pharmacist

100% Remote | TN License Required | Entry-Level

Job Description

This position involves reviewing Utilization Management requests such as formulary exceptions, prior authorizations, step therapy, and quantity limit exceptions for commercial members. The role requires detailed clinical evaluation based on client-specific criteria to approve or deny requests, providing clinical judgment and effective communication.

Responsibilities

• Conduct clinical evaluations for coverage determination requests, including PA or other UM programs like quantity limits, step therapy, formulary exceptions, and tier exceptions.

• Consult directly with healthcare providers or members about non-formulary and clinical product coverage issues.

• Collaborate with team members to ensure consistency in decision-making across the pharmacist team.

• Participate in routine and structured touchpoints with management and team members.

• Complete cases efficiently, maintaining a quality score of 95% or higher.

• Demonstrate a strong attendance record and excellent communication skills.

Requirements

• Doctor of Pharmacy (PharmD) or Bachelor of Science in Pharmacy.

• Current Tennessee pharmacist license in good standing with the State Board of Pharmacy.

• Ability to prioritize tasks and manage multiple projects.

• Ability to make independent clinical decisions.

Additional Skills & Qualifications

• Proficient in learning new computer systems, basic IT troubleshooting, and using multiple monitors.

• Experience with Word and Excel.

• Ability to type 45+ WPM.

• Experience with Pharmacy Benefits Management is a plus but not required.

Job Type & Location

This is a Contract position based out of Nashville, TN.

Pay and Benefits

The pay range for this position is $55.00 - $55.00/hr.

Individual compensation offered for this position within this range will depend on many factors, including qualifications, skills, relevant experience, job knowledge, geographic location, internal equity, and other pertinent job-related factors.

Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: • Medical, dental & vision • Critical Illness, Accident, and Hospital • 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available • Life Insurance (Voluntary Life & AD&D for the employee and dependents) • Short and long-term disability • Health Spending Account (HSA) • Transportation benefits • Employee Assistance Program • Time Off/Leave (PTO, Vacation or Sick Leave)

Workplace Type

This is a fully remote position.

Application Deadline

This position is anticipated to close on Sep 11, 2026.

About Actalent

Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 20,000 consultants and 5,000 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500. We are proud to be an Engineering News-Record (ENR) Top 500 Design Firm for our engineering design services and a ClearlyRated Best of Staffing® winner for both client and talent service.

The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please email View email address on click.appcast.io for other accommodation options.

San Francisco Fair Chance Ordinance: Pursuant to the San Francisco Fair Chance Ordinance, for all positions located in the city and county of San Francisco, we will consider for employment qualified applicants with arrest and conviction records.

Massachusetts Lie Detector: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.

Use of Artificial Intelligence (AI): We may use Artificial Intelligence (AI) to support parts of our hiring process, including sourcing, screening, and evaluating candidates. AI helps assess applications and qualifications, but final decisions are made by our hiring team. By applying, you acknowledge and agree that your application may be reviewed using AI tools.