Remote PBM Pharmacist

Job Summary

A company is looking for a Remote PBM Pharmacist.

Key Responsibilities

• Review and process prior authorizations, coverage determinations, and Medicare appeals
• Evaluate clinical documentation to support approval/denial decisions
• Ensure compliance with CMS and Medicare Part D guidelines and timelines

Required Qualifications

• Active Pharmacist (RPh) license in state of residence (must be in good standing)
• Bachelor's Degree in Pharmacy or PharmD
• Strong computer skills (Excel and Word required)
• Ability to work independently in a remote, productivity-driven environment
• Dedicated, quiet workspace for remote work