Remote PBM Pharmacist
Job Description
-Line Staffing is now hiring Clinical Pharmacist – Prior Authorization / Medicare (Remote) in United States. The Clinical Pharmacist would be working for a Fortune 500 healthcare company and has career growth potential. This would be full time / 40+ hours per week.
Clinical Pharmacist – Prior Authorization / Medicare Compensation
- The pay for this position is $53.00 per hour
- Benefits are available to full-time employees after 90 days of employment
- A 401(k) with a company match is available for full-time employees with 1 year of service on our eligibility dates
Clinical Pharmacist – Prior Authorization / Medicare Highlights
This position is a contract assignment with potential to hire on permanently based upon attendance, performance, and business needs
The required availability for this position is:
- Training: Monday – Friday, 9:00 AM – 5:30 PM EST (first 8 weeks, no time off permitted)
- Post-Training:
- Shifts between 7:00 AM – 8:00 PM EST (Mon–Fri)
- 7:00 AM – 4:30 PM EST (Sat–Sun)
- Includes weekend rotation or 1 weekend day
Clinical Pharmacist – Prior Authorization / Medicare Responsibilities
- Review and process prior authorizations, coverage determinations, and Medicare appeals
- Evaluate clinical documentation to support approval/denial decisions
- Ensure compliance with CMS and Medicare Part D guidelines and timelines
- Perform outbound provider outreach to obtain additional clinical information
- Accurately document all case activity in internal systems
- Meet productivity and quality standards in a high-volume environment
- Utilize drug compendia and clinical guidelines for decision-making
Clinical Pharmacist – Prior Authorization / Medicare Requirements
- Active Pharmacist (RPh) license in state of residence (must be in good standing)
- Bachelor’s Degree in Pharmacy or PharmD
- Strong computer skills (Excel and Word required)
- Ability to work independently in a remote, productivity-driven environment
- Experience with data entry and navigating multiple systems/screens
- Dedicated, quiet workspace for remote work
- Wired internet connection (minimum 25 Mbps download / 5 Mbps upload)
- Ability to sit and focus for the duration of the shift
High School Diploma or GED
- Attendance is mandatory for the first 90 days
Clinical Pharmacist – Prior Authorization / Medicare Preferred Qualifications
- Prior experience in Managed Care or PBM environment
- Experience with prior authorizations, appeals, or coverage determinations
- Medicare Part D knowledge
- Previous remote or production-based pharmacist experience
- Knowledge of Access, PowerPoint, and Visio
If you think this Clinical Pharmacist – Prior Authorization / Medicare (Remote) position is a good fit for you, please reach out to me – feel free to call, e-mail, or apply to this posting!
Job Requirements
Please apply and contact Brad Zidek at 412-823-2500 or email at bzidek@alinestaffing.com for immediate consideration!!