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Hiring For Clinical Pharmacist - Prior Authorization Remote Role

LancesoftWoonsocket, RI

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Overview

Remote
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Job Description

Job ID: 26-81671 Job Title: ‘Clinical Pharmacist - Prior Authorization’ Position Type: Full-Time Contract Role Location: Remote Work Type: Remote Est. Pay Range: $65.00/Hour to $70.00/Hour on W2 (USD) Schedule: Monday-Friday 10 AM-6: 30 PM AZ Time (Mon-Fri 8AM-4: 30 PM AZ Time [training (8 weeks)]Description: Medicaid Prior Authorization Pharmacist. This is a Clinical Pharmacist Position supporting Medicaid Prior Authorization.  The position is remote. An active AZ or TX pharmacist license that is in good standing is required.   Must be ok with these hours (AZT time zone)Duties    Review, assess, adjudicate medication prior authorization requests for medical necessity, clinical appropriateness, and formulary compliance. Apply evidence-based clinical guidelines, drug compendia, FDA labeling, and plan-specific criteria to authorization decisions. Evaluate patient-specific factors including diagnosis, laboratory results, prior therapy, dosing, contraindications, and comorbid conditions. Authorize, modify, or deny medication requests and document clinical rationale clearly and accurately. Collaborate with pharmacy technicians, nurses, medical directors, and other clinical staff to resolve complex cases. Support peer-to-peer reviews and prepare clinical summaries when escalation is required. Ensure compliance with state and federal regulations, accreditation standards (e.G. NCQA, URAC), and internal audit requirements. Maintain productivity, turnaround time, and quality benchmarks for prior authorization processing. Document all activities accurately within prior authorization and pharmacy management systems.Experience    Active and unrestricted AZ or TX pharmacist license. Experience with clinical decision-making while applying evidence based clinical guidelines/criteria;utilizing formularies/preferred drug lists. Experience working in a high production team environment. 3+ years experience working as a pharmacist. Knowledge of clinical program components, formulary designs, and prescription benefit trends.Position Summary    The Prior Authorization Pharmacist is responsible for reviewing and evaluating medication prior authorization requests to ensure appropriate, safe, and cost-effective therapy in accordance with clinical guidelines, regulatory requirements, and organizational policies. This role applies clinical judgement to support optimal patient outcomes while balancing utilization management objectives.Education   Bachelor's degree in pharmacy or Pharm D. Required with at least two years experience as a pharmacist.  Must have an active license in good standing. If you believe you're qualified for this position and are currently in the job market or interested in making a change, please give me a call as soon as possible at 571 678 0714.

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FAQs About Hiring For Clinical Pharmacist - Prior Authorization Remote Role Jobs at Lancesoft

What is the work location for this position at Lancesoft?
This job at Lancesoft is located in Woonsocket, RI, according to the details provided by the employer. Some roles may also include multiple work locations depending on the requirement.
What pay range can candidates expect for this role at Lancesoft?
Candidates can expect a pay range of $65.75.
What employment applies to this position at Lancesoft?
The employer has not provided this information. This may be discussed during the hiring process.
What is the process to apply for this position at Lancesoft?
You can apply for this role at Lancesoft either through Sonara's automated application system, which helps you submit applications 10X faster with minimal effort, or by applying manually using the direct link on the job page.