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Prior Authorization Pharmacist (PBM) - Remote

A-Line Staffing Solutions

  • 16 days ago
  • Remote
  • $53 Per Hour
  • Full-time

Highlights

Seeking an experienced Pharmacist to complete criteria-based clinical reviews and render prior authorization coverage determinations based on plan design, clinical guidelines, and regulatory requirements. This role supports specialty and non-specialty pharmacy programs and includes high-volume provider interaction.

Numbers & Facts

Location (
Remote)
Job TypeFull-time
IndustryStaffing/Employment Agencies
Salary$53 Per Hour
Year Founded2004
HeadquartersUtica, MI, US
Websitehttp://www.alinestaffing.com/

Description

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 work one weekend day each week on one of these schedules:

Sun–Thu or Tue–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 complete criteria-based clinical reviews and render prior authorization coverage determinations based on plan design, clinical guidelines, and regulatory requirements. This role supports specialty and non-specialty pharmacy programs and includes high-volume provider interaction.

Job Responsibilities

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

Qualifications

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 work CST hours and one 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)

About Company

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

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