Pharmacist Operations Advisor - Remote (170457)
Job Description
Job Title: Pharmacist Operations Advisor
Pay Rate: $53.00 per hour
Location: Remote (Nation Wide)
Start Date: 07/19/2026
End Date: 01/19/2027
Position Type: Temp to Perm (opportunity to extend or go permanent based on business needs)
Job Summary:
As a Pharmacist Operations Advisor, you will support Medicare Part D members and providers with pharmacy benefit-related requests. This role is responsible for accurate case setup, clinical review, provider outreach, documentation, and ensuring compliance with Medicare guidelines and timelines. This is an excellent opportunity to work in a fast-paced, productivity-driven healthcare environment while delivering a best-in-class member experience.
Key Responsibilities:
- Review and process Medicare Part D appeals and pharmacy benefit requests
- Ensure accurate case setup and complete clinical review documentation
- Review internal notes and fax requests for pertinent information
- Contact providers for additional clinical information when needed
- Utilize Medicare guidelines, work instructions, and drug compendia resources
- Ensure compliance with CMS mandated timelines and quality standards
- Maintain accurate and concise documentation throughout the review process
- Apply clinical judgment and pharmacy knowledge to case decisioning
- Participate in coaching and development discussions with leadership
- Navigate multiple systems and applications while maintaining productivity standards
Schedule:
- Business Hours: 7:00 AM – 8:00 PM EST Monday through Friday
- Weekend Hours: 7:00 AM – 4:30 PM EST Saturday and Sunday
- Set rotation schedule after training
- Candidates must be flexible to work assigned 8-hour shifts based on business needs
- After training, schedules may include one weekend day or weekend rotation
Training Requirements:
- Attendance is mandatory during the first 8–10 weeks of training
- Must be available Monday through Friday from 9:00 AM – 5:30 PM EST during training
- No planned vacation or scheduling conflicts during training period
Required Qualifications:
- Active Pharmacist license in good standing in state of residence
- Must provide screenshot of active pharmacist license showing name, state, and active dates
- Must provide internet speed test screenshot from www.speedtest.net
- Wired internet connection with minimum speeds of 25 Mbps download and 5 Mbps upload
- Ability to sit and focus for the duration of scheduled shifts without interruptions
- Ability to work independently in a productivity-driven remote environment
- Strong computer literacy skills
- Experience navigating multiple computer applications and dual screens
- Strong attention to detail and documentation skills
- Ability to comply with CMS and Medicare guidelines
Preferred Qualifications:
- Knowledge of Access, PowerPoint, and Visio
- Proficiency with Excel and Word
- Data entry experience
- Previous experience in a productivity-driven work environment
- Positive attitude and strong team engagement skills
Interview Process:
- Virtual interviews conducted via Microsoft Teams
- Candidates must be comfortable being on camera during training and meetings
Important Candidate Information:
- This is a work-from-home position requiring a dedicated, quiet workspace
- Possible outbound provider calls may be required
- Safety Sensitive position
Benefits:
Benefits are available to full-time employees after 90 days of employment.
A 401(k) with company match is available after 1 year of service.
- Dental insurance
- Health insurance
- Life insurance
- Vision insurance
Application Question(s):
- Do you agree to this schedule?
Business Hours: 7:00 AM – 8:00 PM EST Monday through Friday
Weekend Hours: 7:00 AM – 4:30 PM EST Saturday and Sunday
Set rotation schedule after training
Must be flexible to work assigned 8-hour shifts based on business needs
After training, schedules may include one weekend day or weekend rotation
Training Requirements:
Attendance is mandatory during the first 8–10 weeks of training
Must be available Monday through Friday from 9:00 AM – 5:30 PM EST during training
No planned vacation or scheduling conflicts during training period
Experience:
- Reviewing and processing Medicare Part D appeals: 1 year (Required)
- Reviewing and processing pharmacy benefit requests: 1 year (Required)
License/Certification:
- Pharmacy License (Required)
Work Location: Remote
Job Requirements
Application Question(s): Do you agree to this schedule?
Business Hours: 7:00 AM – 8:00 PM EST Monday through Friday
Weekend Hours: 7:00 AM – 4:30 PM EST Saturday and Sunday
Set rotation schedule after training
Must be flexible to work assigned 8-hour shifts based on business needs
After training, schedules may include one weekend day or weekend rotation
Training Requirements:
Attendance is mandatory during the first 8–10 weeks of training
Must be available Monday through Friday from 9:00 AM – 5:30 PM EST during training
No planned vacation or scheduling conflicts during training period