Clinical Pharmacist
HireTalent - Staffing & Recruiting Firm · United States
Apply & track with Apply EdgeJob Title:100% REMOTE Clinical Pharmacist đJoin a growing healthcare organization where your clinical expertise directly impacts patient access to life-changing medications.We are seeking experienced Clinical Pharmacists to join a dynamic team responsible for reviewing medication authorization requests and ensuring evidence-based, patient-focused coverage decisions. This is an excellent opportunity for pharmacists who enjoy applying clinical knowledge, collaborating with healthcare providers, and working in a managed care environment.What You'll Doâ
Review and evaluate prior authorization requests for specialty and non-specialty medicationsâ
Apply clinical guidelines and medical necessity criteria to make coverage determinationsâ
Assess appeals and reconsideration requestsâ
Conduct peer-to-peer discussions with prescribing physicians when neededâ
Support quality assurance initiatives and clinical auditsâ
Provide expertise and guidance to internal teams on pharmacy-related questionsâ
Help ensure safe, appropriate, and cost-effective medication useâ
Maintain compliance with all applicable regulations and industry standardsWhat We're Looking ForRequired QualificationsDoctor of Pharmacy (PharmD)Active, unrestricted Pharmacist license3+ years of pharmacist experiencePrior authorization, utilization management, or clinical review experienceExperience working within a health plan, managed care, PBM, or insurance environmentStrong understanding of clinical criteria and medication coverage decisionsExcellent communication skills and confidence speaking with physicians and healthcare providersPreferred QualificationsBoard Certification (BCPS, BCOP, or similar)Pharmacy residency trainingExperience developing or applying clinical review criteriaBackground in retail, hospital, specialty, or managed care pharmacySchedule & Work Environment100% Remote (CST hours)Full-time, 40 hours per weekDay shift scheduleWeekend coverage required (one weekend day per week after onboarding period)Comprehensive training program provided-first 3-4 weeksMonday-Friday8:00 AM - 5:00 PM CSTEligible LocationsCandidates must reside in one of the approved U.S. states. Remote work is not available in California, Florida, Alaska, Delaware, Hawaii, Louisiana, Montana, North Dakota, Oklahoma, West Virginia, or WyomingWhy This Opportunity?â Join a high-growth healthcare organizationâ Gain valuable prior authorization and managed care experienceâ Work remotely from homeâ Be part of a collaborative pharmacy operations teamâ Opportunity for contract extension and career growthInterested? Apply today with your updated resume and active unrestricted state pharmacist license details. These openings are expected to move quickly. đ