Licensed Prior Authorization Pharmacist

Job Summary

Working remotely in a full-time capacity, the Licensed Prior Authorization Pharmacist will make determinations on prior authorization requests for pharmaceutical coverage, ensuring compliance with established guidelines and regulations while managing high-volume workloads.

Key responsibilities

• Evaluate prior authorization requests to determine medical necessity and benefit decisions
• Collaborate with team members to meet quality standards and customer performance guarantees
• Provide clinical support and engage with providers to assist in determinations

Required qualifications

• Bachelor's Degree in Pharmacy or related field
• Current active pharmacist license in good standing in any U.S. state
• Minimum of 5 years of experience as a Registered Pharmacist
• 3-5 years of experience with prior authorization processes and clinical criteria application
• Experience managing high-volume prior authorization workloads independently