Vermont Licensed Prior Authorization Pharmacist

Supporting clinical review and decision-making, the remote Vermont Licensed Prior Authorization Pharmacist will manage pharmacy prior authorization and appeals requests while collaborating with providers and internal teams to ensure timely and compliant determinations. Key responsibilities: Review and process prior authorization and appeals requests using clinical criteria and regulatory guidelines Navigate multiple systems to research medication information and document case resolutions accurately Communicate with members and providers to clarify prior authorization requirements and provide updates on case status Required qualifications: Bachelor of Pharmacy or Doctor of Pharmacy degree from an accredited program and an active pharmacist license Current, unrestricted pharmacist license in Vermont or Maine Intermediate proficiency with Microsoft Office applications Ability to work flexible hours, including weekends and holidays as required Residence in Vermont or Maine