Texas Licensed Prior Authorization Pharmacist

Job Summary

A company is looking for a Prior Authorization Pharmacist to support their Specialty Infusion Pharmacy remotely.

Key Responsibilities

• Conduct comprehensive clinical reviews for specialty pharmacy and infusion therapy prior authorization requests
• Evaluate clinical documentation against payer-specific medical necessity criteria and prepare prior authorization requests
• Communicate with Pharmacy Benefit Managers (PBMs) and health plans to resolve authorization issues and mitigate denials

Required Qualifications

• Doctor of Pharmacy (PharmD) or Bachelor of Pharmacy from an accredited institution
• Active, unrestricted U.S. pharmacist license
• 2+ years of experience in prior authorization or managed care pharmacy operations
• Strong understanding of drug therapy, clinical guidelines, and specialty medications
• Proficiency in pharmacy benefit systems and prior authorization platforms