Clinical Pharmacist – Prior Authorization / Medicare - {168034}

A-Line Staffing is now hiring Clinical Pharmacist – Prior Authorization / Medicare (Remote) in United States. The Clinical Pharmacist would be working for a Fortune 500 healthcare company and has career growth potential. This would be full time / 40+ hours per week.

Clinical Pharmacist – Prior Authorization / Medicare Compensation

· The pay for this position is $53.00 per hour

· Benefits are available to full-time employees after 90 days of employment

· A 401(k) with a company match is available for full-time employees with 1 year of service on our eligibility dates

Clinical Pharmacist – Prior Authorization / Medicare Highlights

This position is a contract assignment with potential to hire on permanently based upon attendance, performance, and business needs

The required availability for this position is:

• Training: Monday – Friday, 9:00 AM – 5:30 PM EST (first 8 weeks, no time off permitted)
• Post-Training:
• • Shifts between 7:00 AM – 8:00 PM EST (Mon–Fri)
  • 7:00 AM – 4:30 PM EST (Sat–Sun)
  • Includes weekend rotation or 1 weekend day

Clinical Pharmacist – Prior Authorization / Medicare Responsibilities

• Review and process prior authorizations, coverage determinations, and Medicare appeals
• Evaluate clinical documentation to support approval/denial decisions
• Ensure compliance with CMS and Medicare Part D guidelines and timelines
• Perform outbound provider outreach to obtain additional clinical information
• Accurately document all case activity in internal systems
• Meet productivity and quality standards in a high-volume environment
• Utilize drug compendia and clinical guidelines for decision-making

Clinical Pharmacist – Prior Authorization / Medicare Requirements

• Active Pharmacist (RPh) license in state of residence (must be in good standing)
• Bachelor’s Degree in Pharmacy or PharmD
• Strong computer skills (Excel and Word required)
• Ability to work independently in a remote, productivity-driven environment
• Experience with data entry and navigating multiple systems/screens
• Dedicated, quiet workspace for remote work
• Wired internet connection (minimum 25 Mbps download / 5 Mbps upload)
• Ability to sit and focus for the duration of the shift

High School Diploma or GED

·         Attendance is mandatory for the first 90 days

Clinical Pharmacist – Prior Authorization / Medicare Preferred Qualifications

• Prior experience in Managed Care or PBM environment
• Experience with prior authorizations, appeals, or coverage determinations
• Medicare Part D knowledge
• Previous remote or production-based pharmacist experience
• Knowledge of Access, PowerPoint, and Visio

If you think this Clinical Pharmacist – Prior Authorization / Medicare (Remote) position is a good fit for you, please reach out to me – feel free to call, e-mail, or apply to this posting!