Job Title: Remote Prior Authorization Pharmacist (PharmD Required)
Location: Fully Remote (Work from Home, Florida)
Key Responsibilities:
• Conduct thorough utilization management reviews, including prior authorizations, appeals, and denials for prescription medications.
• Apply clinical knowledge to evaluate requests against insurance policies, FDA guidelines, and evidence-based medicine.
• Communicate decisions effectively to healthcare providers, patients, and internal teams via phone, email, or secure portals.
• Document all reviews accurately in electronic systems to ensure compliance with CMS, state regulations, and health plan policies.
• Collaborate with medical directors and utilization management teams on complex cases to optimize patient outcomes.
• Contribute to process improvements for faster turnaround times in prior authorization workflows.
Qualifications and Requirements:
• Doctor of Pharmacy (PharmD) degree from an accredited institution. 20
• Active, unrestricted pharmacist license in at least one U.S. state (multi-state licensure preferred for remote work).
• 1-3 years of experience in clinical pharmacy, prior authorization, or managed care (entry-level considered for strong candidates).
• Proficiency in pharmacology, insurance verification, and electronic health records (EHR) systems.
• Strong communication, analytical, and problem-solving skills for handling remote pharmacist duties.
• Reliable home office setup with high-speed internet for secure, confidential work.
Job Types: Full-time, Contract
Pay: $60.65 - $65.04 per hour
Expected hours: No less than 40 per week
Benefits:
• Flexible schedule
Education:
• Doctorate (Required)
License/Certification:
• Licensed Pharmacist (Required)
Location:
• Florida (Required)
Work Location: Remote
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