Pharmacist (PA)
Posted 08/27/2026
Job ID:
{175162}
Job Description
Remote Prior Authorization Pharmacist
Pay: $53.00/hour
Work Arrangement: Remote
Schedule: Sunday–Thursday or Tuesday–Saturday
Time Zone: CST
Position Summary
We are seeking an experienced Pharmacist to review and process prior authorization requests while ensuring accuracy, medical necessity, regulatory compliance, and timely coverage determinations.
Key Responsibilities
- Review prior authorization requests for accuracy, appropriateness, and medical necessity.
- Gather and evaluate clinical information, coverage policies, and authorization criteria.
- Make coverage determinations in accordance with regulatory and plan guidelines.
- Process Medicare Part D approvals and denials.
- Clearly communicate approval, denial, and incomplete-request decisions to providers and patients.
- Consult with physicians and healthcare providers regarding complex cases.
- Manage approximately 40 prior authorization cases per day.
- Handle approximately 50 inbound and outbound provider calls daily.
- Document clinical reviews, decisions, and communications accurately.
- Support process improvements designed to increase accuracy, streamline workflow, and reduce turnaround times.
Qualifications
- Active Pharmacist license required.
- 2+ years of prior authorization review experience required.
- PBM, managed care, or health plan experience strongly preferred.
- Specialty pharmacy experience is a plus.
- Strong clinical judgment, communication, and documentation skills.
- Experience working remotely preferred.
- Ability to work high-volume cases and provider interactions.
- Must be available for the entire training period.
- Candidates must work one weekend day each week.
- Candidates must be located in the continental U.S.; New Mexico and Colorado are excluded.
Tdavis@alinestaffing.com