Clinical Pharmacist Advisor – Medicare (Remote)
A-Line Staffing Solutions LLC
Atlanta, GA(remote)
A-Line Staffing is now hiring a Clinical Pharmacist Advisor – Medicare (Remote) . This position offers competitive pay and the opportunity to support Medicare Part D members in a high-volume, production-driven clinical review environment with a leading healthcare organization.
Clinical Pharmacist Advisor Compensation
- Pay Rate: $53.00/hour
Clinical Pharmacist Advisor Highlights
- Location: 100% Remote (U.S.)
- Assignment Type: Contract to Hire
- Work Setting: Work from Home
Schedule
Training:
- Monday – Friday, 9:00 AM – 5:30 PM EST (first 8 weeks, no time off allowed)
Post-Training:
- Monday – Friday: 7:00 AM – 8:00 PM EST
- Saturday – Sunday: 7:00 AM – 4:30 PM EST
- Set schedule with rotating weekends or 1 weekend day required
Additional Information
- Safety-sensitive role
- Camera required during training and team meetings
- High-volume, productivity-based environment
- Strong potential for full-time conversion based on performance
Clinical Pharmacist Advisor Responsibilities
- Review and process Medicare Part D prior authorizations, coverage determinations, and appeals
- Evaluate clinical documentation and make determinations using CMS guidelines and drug compendia
- Ensure accurate case setup and timely processing of requests
- Conduct outreach to providers for additional clinical information as needed
- Maintain detailed and compliant documentation for all cases
- Meet departmental productivity and quality standards
- Work independently while managing a high-volume workload
Clinical Pharmacist Advisor Requirements
- Active Pharmacist (RPh) license in state of residence (must be in good standing)
- Bachelor’s Degree in Pharmacy or PharmD required
- Strong clinical judgment and attention to detail
- Ability to work independently in a remote, production-driven environment
- Proficiency with computers, including Excel and Word
- Experience navigating multiple systems and performing data entry
Preferred Qualifications
- Experience with Medicare Part D, PBM, or managed care environments
- Prior authorization, appeals, or formulary review experience
- Previous remote pharmacist or high-volume review experience
- Knowledge of Access, PowerPoint, or Visio
Work From Home Requirements
- Dedicated, quiet workspace
- Wired internet with minimum speeds: 25 Mbps download / 5 Mbps upload
- Ability to remain focused and interruption-free for full shift
- Dual monitor setup preferred
Benefits
- Benefits available to full-time employees after eligibility period
- 401(k) options available after 1 year
If you think this Clinical Pharmacist Advisor – Medicare (Remote) position is a good fit for you, please apply today.
- Review and process Medicare Part D prior authorizations, coverage determinations, and appeals
- Evaluate clinical documentation and make determinations using CMS guidelines and drug compendia
- Ensure accurate case setup and timely processing of requests
- Conduct outreach to providers for additional clinical information as needed
- Maintain detailed and compliant documentation for all cases
- Meet departmental productivity and quality standards
- Work independently while managing a high-volume workload
About the Company
A-Line Staffing Solutions LLC
A-Line Staffing Solutions is a premier staffing company that supplies professionals to the Healthcare, Insurance, Pharmaceutical, and Information Technology industries. Founded in 2004, A-Line Staffing Solutions has been a leader in matching talented individuals to the jobs that our clients NEED to fill. We are experts at offering creative staffing solutions to employers, and we are hiring every day. A-Line Staffing can offer short-term, long-term and direct-hire opportunities to professionals across the United States. We hire only the most qualified and talented individuals in the country. Our recruiting, selection and stringent screening processes have strengthened our reputation for delivering quality customer service and unbeatable talent. For our commissioned clients, A-Line Staffing closely follows the standards and practices established by The Joint Commission. For all of our clients and employees, our commitment to continual improvement combined with a strict code of ethics provides an atmosphere of respect and unparalleled professionalism. To find out how A-Line Staffing Solutions can share our talent with you, please contact us today. We are eager to include you among our most valued and satisfied clients. If you are a professional and would like to learn more about open opportunities in your area, please contact us today. We are always searching for talented and enthusiastic professionals