Remote Pharmacist Location: Remote Pay: $53.00/hour Schedule: Full-Time Shifts Available: Sunday–Thursday Tuesday–Saturday Available Shifts (CST) 10:30 AM–7:00 PM 11:00 AM–7:30 PM 11:30 AM–8:00 PM Job Duties: Evaluate and review all prior authorization requests and render coverage determinations based on clinical criteria and plan design. Includes verifying insurance coverage and eligibility, interpreting clinical guideline criteria, consulting physicians and other healthcare providers, and appropriately utilizing clinical knowledge and resources while complying with department protocols. One of the crucial responsibilities is to guarantee that the decisions regarding cases are conveyed promptly and efficiently to all the healthcare providers, health plans/employers, patients, and other healthcare professionals following agreed-upon approval & denial management processes. Collaborates with the technicians and prior authorization team members to process referrals, including answering clinical questions and collecting appropriate clinical/medical data needed to perform clinical assessments and reviews as per the health plan/employer-agreed criteria within the designated service level agreements. Performs and handles inbound and outbound phone calls with technicians, prior authorization team members, physicians, healthcare providers, and/or patients to facilitate prior authorization requests, answer inquiries, and/or resolve escalations. Requirements: Hold an active Pharmacist license applicable to the position. Have strong clinical knowledge and attention to detail. Demonstrate excellent communication and customer-service skills. Be comfortable working independently in a remote environment. Have reliable technology and internet connectivity that meet the requirements above. Be available to work one of the designated Sunday–Thursday or Tuesday–Saturday schedules. Maintain strict confidentiality and comply with all applicable privacy and information-security requirements This is an excellent opportunity for an experienced Pharmacist seeking a remote position with consistent scheduling and comprehensive training.
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