Remote Clinical Prior Authorization Pharmacist

Remote Clinical Pharmacist - Prior Authorizations Pay: $53.00 per hour Job Type: Remote Contract Opportunity Schedule: Flexible 8-hour shifts between 7:00 AM - 10:00 PM CST Training Schedule: Monday-Friday, 8:00 AM - 4:30 PM CST for approximately 6 weeks Location: Fully Remote
Make an Impact on Patient Access to Specialty Medications Are you a licensed pharmacist with experience in prior authorization, specialty medications, or clinical reviews? This is an opportunity to use your clinical expertise to help patients access critical therapies while working remotely in a collaborative healthcare environment. We are seeking a Remote Clinical Pharmacist - Specialty Medical Prior Authorization to perform clinical assessments, review medical information, communicate with healthcare providers, and support authorization decisions for specialty medication programs. This role is ideal for pharmacists who enjoy applying evidence-based clinical knowledge, working with healthcare professionals, and making a direct impact on patient care.
Minimum 1 year of related clinical prior authorization experience or health plan remote/call center environment experience Experience with specialty medications or clinical review of authorization requests preferred Active pharmacist license in your state of residence required
Key Responsibilities Perform clinical reviews of specialty medication prior authorization requests using established clinical criteria and guidelines.
Evaluate medical documentation and clinical information to support authorization decisions.
Review cases for prospective and concurrent utilization management.
Collaborate with pharmacy technicians, nurses, providers, and healthcare professionals to collect necessary clinical information.
Handle inbound calls from physicians, healthcare providers, and members regarding pending, approved, and denied authorization requests.
Communicate case outcomes and decisions professionally and accurately.
Maintain detailed documentation within clinical systems.
Stay current on specialty medications, disease states, and applicable clinical guidelines.
Support quality, compliance, and operational performance goals.
Required Qualifications Active pharmacist license in your state of residence in good standing.
Bachelor’s Degree in Pharmacy or Doctor of Pharmacy (PharmD).
Minimum of 1 year of related prior authorization, utilization management, or clinical review experience or health plan remote/call center environment experience required.
PBM or health plan prior authorization experience required.
Strong knowledge of specialty medications and clinical review processes.
Excellent written and verbal communication skills.
Strong organizational skills and attention to detail.
Ability to navigate multiple computer systems and Windows-based applications.
Preferred Qualifications Experience supporting specialty pharmacy programs.
Experience reviewing medical necessity criteria.
Background in utilization management, pharmacy benefits, or managed care.
Experience communicating with physicians, health plans, and healthcare providers.
Remote Work Requirements Reliable high-speed internet connection.
Minimum requirement: 25 Mbps download and 3 Mbps upload speed.
Dedicated private workspace used exclusively for business purposes during scheduled hours.
Smartphone capable of supporting secure authentication applications.
Ability to maintain HIPAA-compliant privacy standards while working remotely.
Candidates will be required to provide: Copy of active pharmacist license.
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Schedule Details Remote position with 8-hour daily shifts. Scheduling window: 7:00 AM - 10:00 PM CST. Monday-Friday training schedule for approximately 6 weeks. Weekend availability may be required.
Why Join This Opportunity? Competitive pay of $53.00 per hour
Fully remote flexibility
Opportunity to leverage your pharmacy expertise beyond traditional practice settings
Work with specialty medication programs impacting patient care
Collaborative environment supporting healthcare innovation
Meaningful role connecting clinical knowledge with improved access to therapy

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