Remote Prior Authorization Pharmacist Job at Pharmacy Careers, Birmingham, AL

b2NMSk9TVnI0NG8vaVNDaDFYZWhoWjFXRHc9PQ==
  • Pharmacy Careers
  • Birmingham, AL

Job Description

Remote Prior Authorization Pharmacist – Work From Home in Managed Care

A confidential managed care organization is seeking a motivated Remote Prior Authorization Pharmacist to evaluate prescription requests, ensure medical necessity, and improve patient access to safe and effective therapies. This work-from-home position is ideal for pharmacists who want to transition out of retail or hospital settings while building expertise in managed care.

Key Responsibilities
  • Review prior authorization requests for accuracy, appropriateness, and clinical necessity.
  • Apply plan criteria, evidence-based guidelines, and regulatory standards to determinations.
  • Communicate approval/denial decisions clearly to providers and patients.
  • Collaborate with physicians, nurses, and medical directors on complex cases.
  • Document outcomes in compliance with health plan policies and CMS/state regulations.
  • Support process improvements to streamline workflow and turnaround times.


What You’ll Bring

  • Education: Doctor of Pharmacy (PharmD) or Bachelor of Pharmacy degree.
  • Licensure: Active and unrestricted pharmacist license in the U.S.
  • Experience: Prior authorization, utilization management, or managed care preferred — retail or hospital pharmacists with strong clinical judgment are encouraged to apply.
  • Skills: Excellent clinical review, documentation, and communication skills.

Why This Role?

  • Flexibility: 100% remote work from home with flexible scheduling options.
  • Impact: Directly influence patient access to safe and cost-effective medications.
  • Growth: Build specialized skills in utilization management and managed care.
  • Rewards: Competitive compensation, benefits, and career advancement opportunities.


About Us
We are a c onfidential healthcare partner working with health plans and PBMs across the U.S. . Our pharmacists ensure patients receive the right therapy at the right time while maintaining compliance with all regulations.

Apply Today
Take the next step in your career with our Remote Prior Authorization Pharmacist opportunity — and enjoy the benefits of working from home while shaping the future of managed care.

Job Tags

Remote work, Flexible hours,

Similar Jobs

Crime Scene Resources, Inc

Forensic Intern/Administrative Intern Job at Crime Scene Resources, Inc

 ...Requirements Click to read more Duties Examples of Essential Functions The essential functions typically performed by the Forensic Intern (Administrative Intern) assigned to the Ontario Police Department include the following: Provides clerical support... 

Volanno

Mail Clerk Job at Volanno

Full-time Description The Mail Clerk performs routine mailroom and messenger duties to ensure the accurate and timely distribution of incoming and outgoing correspondence throughout the organization. This role supports daily mail operations maintains efficient workflow...

Enterprise Medical Recruiting

Family Medicine with Excellent Earnings in Beautiful Salem, OR Job at Enterprise Medical Recruiting

 ...the Cascade Mountains and the ocean beaches. Salem is in the midst of sustained, steady growth. Ongoing preservation of historic downtown buildings, along with a downtown core master plan for residential and commercial development, ensures managed growth. GJ-2303... 

AO Globe Life

Work from Home Customer Service Representative | No Experience Required | START ASAP | Most Responsive ™ Job at AO Globe Life

 ...Now Hiring: Work from Home Customer Service Representative Most Responsive No Experience Required | Immediate Start | Full Training Provided Company : Globe Life...  ...U.S. Based Only Employment Type : Full-Time or Part-Time Compensation : Weekly Commission based... 

V R Della Infotech Inc

Medical Laboratory Technician Job at V R Della Infotech Inc

 ...and procedures. Performs all testing under the supervision of a Laboratory Department Manager, Laboratory Site Manager /Supervisor or...  ...school diploma or equivalent with 50-week military training as Medical Lab Specialist or graduate of an approved Medical Laboratory or...