Remote Clinical Pharmacist

Job Summary We are seeking a qualified pharmacy professional with prior experience in Pharmacy Benefit Management (PBM) or Prior Authorization. The ideal candidate will be responsible for reviewing prior authorization requests, evaluating clinical criteria, and ensuring compliance with established policies and procedures.

Responsibilities

Review and process prior authorization requests in accordance with established policies and procedures. Evaluate submitted documentation and verify that requests meet the required clinical criteria. Ensure accurate and timely completion of prior authorization reviews. Maintain detailed documentation of reviews and decisions. Communicate effectively with healthcare providers and other stakeholders regarding authorization requirements. Follow applicable regulatory guidelines and organizational procedures. Maintain confidentiality and accuracy when handling patient and pharmacy information.

Requirements

Previous pharmacy experience in PBM or Prior Authorization. Appropriate state license required. Basic computer skills and proficiency in documentation systems. Strong organizational and interpersonal skills. Excellent attention to detail and accuracy. Ability to follow established policies, procedures, and clinical criteria. Strong communication and problem-solving skills.