Remote / Work from Home Pharmacist - Prior Authorization

Actively Screening for multiple Remote - Pharmacists to join leading pharmacy benefits optimizer based out of Birmingham, AL!

The Clinical Pharmacist supports the review of prior authorization and appeal requests by evaluating clinical documentation and making coverage determinations based on established criteria. This role involves collaborating with prescribers, pharmacies, and internal teams to obtain necessary clinical information, document decisions, and communicate outcomes. The pharmacist ensures reviews are completed accurately, efficiently, and in compliance with applicable regulatory and client requirements while contributing to process improvements within the prior authorization program.

Collaborate with prescribers, pharmacies, and internal teams to gather necessary clinical information.

Document decisions and communicate outcomes effectively.

Ensure reviews are completed accurately and efficiently in compliance with regulatory requirements.

Contribute to process improvements within the prior authorization program.

Prior experience with prior authorization review.

Ability to work efficiently in a production-driven environment while managing multiple high-priority tasks and deadlines.

Strong attention to detail with a commitment to accuracy and quality.

Experience with multiple PBM platforms and payer-specific prior authorization workflows.

Familiarity with medical benefit vs. pharmacy benefit coverage determinations.

Exposure to appeals processing (first-level, second-level, or external review submissions).

Working knowledge of managed care, utilization management, or health plan operations.

Understanding of CMS, state-level, and payer regulatory requirements related to prior authorization.

This is a 100% work-from-home position. The work involves regular use of a computer keyboard, mouse, and calculator. The majority of the workday is spent seated at a desk, with the occasional requirement to lift up to 15 pounds.

This is a Contract position based out of Birmingham, AL.

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.

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)

This is a fully remote position.

This is a Contract position based out of Birmingham, AL.

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.

If eligible, the benefitsavailable for this temporary role may include the following:Medical, dental & visionCritical Illness, Accident, and Hospital401(k) Retirement Plan Pre-tax and Roth post-tax contributions availableLife Insurance (Voluntary Life & AD&D for the employee and dependents)Short and long-term disabilityHealth Spending Account (HSA)Transportation benefitsEmployee Assistance ProgramTime Off/Leave (PTO, Vacation or Sick Leave)

This is a fully remote position.

Application Deadline
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.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 withoutregard to race, sex, age, color, religion, national origin, veteran status, disability,sexual orientation, gender identity, genetic information or any characteristic protectedby law.

If you would like to request a reasonable accommodation, such as the modification oradjustment of the job application process or interviewing process due to a disability,please email View email address on click.appcast.io 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 applicationsand qualifications, but final decisions are made by our hiring team. By applying, youacknowledge and agree that your application may be reviewed using AI tools.

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