Prior Authorization Pharmacist (PBM) - Remote Pay:$53.00 an hr Duration:Contract to hire Start date: 10/12/26 Work Setup:Fully remote (continental U.S.) —cannot be in New Mexico or Colorado Hours:40 hrs/week Schedule (CST hours required) Candidates will workone weekend day each weekon one of these schedules: Sun–ThuorTue–Sat 10:30am–7:00pm CST 11:00am–7:30pm CST 11:30am–8:00pm CST Training (Mandatory) 10/12/2026 – 11/25/2026(first 7 weeks) Mon–Fri, 8:00am–4:30pm CST Position Summary Seeking an experienced Pharmacist to completecriteria-based clinical reviewsand renderprior authorization coverage determinationsbased on plan design, clinical guidelines, and regulatory requirements. This role supports specialty and non-specialty pharmacy programs and includes high-volume provider interaction. Key Responsibilities Review prior authorization requests for accuracy, appropriateness, and medical necessity Interpret clinical criteria and plan guidelines; gather/assess clinical documentation Communicate approvals/denials/incomplete requests to providers and patients Handle high-volume inbound/outbound calls (approx.50 calls/day) Manage a daily workload (approx.40 PA cases/day) Document determinations and communication thoroughly and accurately Support technicians and PA team to meet service level requirements Required Qualifications Active Pharmacist license (required) 2+ years of prior authorization review experience (required) PBM / Managed Care / Health Plan experience (strongly preferred) Specialty pharmacy exposure (plus) Strong communication + documentation skills; comfortable in a high-production environment Able to workCST hoursandone weekend day weekly High school diploma/GED(verifiable) required Bachelor’s in Pharmacy required (PharmD preferred) Remote/Equipment Requirements (Must Meet) Provide your own high-speed internet:minimum 25 Mbps download / 3 Mbps upload Smartphone required(VPN token will be installed on phone) Private, secure workspace (conversations/screens/documents not accessible to others) Must be able to comply with teleworker privacy/security requirements Assignment may be changed to in-office in the future (must acknowledge)
Prior Authorization Pharmacist (PBM) - Remote in miami at Unknown Company
This position is listed as contract and able to be worked remotely.