Clinical Review Pharmacist (Prior Authorizations)

NOW HIRING: Remote Clinical Review Pharmacist (Prior Authorization - Specialty Medications)
Compensation: $53/hour Full-Time Remote Contract Position

We are seeking an experienced and detail-oriented Clinical Review Pharmacist to join our team. This fully remote position involves reviewing clinical data and applying established guidelines to determine prior authorization outcomes for specialty medications.

Key Responsibilities:

• Conduct clinical reviews of medical data collected to perform prior authorization for specialty medications

• Apply clinical knowledge to plan-approved criteria for prospective and concurrent case reviews

• Take inbound calls from physicians or members regarding their pending, approved, or denied prior authorizations

• 100% REMOTE - Can live anywhere in the USA , except HI, NM, ID, MT, AK, WY, SD, ND

• Contract Length: 1 year (approved)

• Target Start Date: July 21, 2025

• Pay Rate: $53 per hour

• Benefits: Available to full-time employees after 90 days (health, dental, vision, life, and short-term disability)

• 401(k): Company match available after 1 year of service (based on eligibility)

First 12 Weeks (Training Period):

• Monday-Friday, 9:00 AM - 5:30 PM ET

• Mandatory attendance, no time off permitted during this period

Post-Training Shift Options (subject to finalization) :

• Option 1: Monday-Friday, 9:00 AM - 5:30 PM ET, with every 4th weekend rotation

• Option 2: Monday-Friday, 11:30 AM - 8:00 PM ET (no weekends)

• Option 3: Tuesday-Saturday, 9:00 AM - 5:30 PM ET (Sunday/Monday off)

Note: Candidates in Pacific or Mountain Time zones may be prioritized for later shifts (e.g., 11:30 AM-8:00 PM ET)

• Prior authorization experience in managed care (health plan) or PBM required

• Must be licensed as a Pharmacist in your state of residence

• Bachelor's degree in Pharmacy or PharmD required

• At least 2 years of experience as a Registered Pharmacist (RPh)

• PBM experience is a plus, but not required

• Open to candidates with hospital, specialty, or mixed pharmacy backgrounds

• Candidates with retail-only pharmacy experience may be less competitive unless supplemented with relevant clinical or managed care skills

Apply Directly or Call Alliston Brown to Learn More:

Join a mission-driven team dedicated to high-quality, patient-centered care-all from the comfort of your home.