Job Description

Job Description

Job Description

Job Opening: Remote Clinical Pharmacist (Prior Authorization Team)
Location: Work from Home (Must be licensed in North Carolina — can reside in any state)
Shift: 11:00 AM – 7:30 PM EST
Contract Type: Contract

Position Summary:

We are seeking a dedicated Clinical Pharmacist to join our Prior Authorization team in a fully remote capacity. This position plays a vital role in ensuring patients receive timely and accurate pharmacy benefits by reviewing and completing criteria-based prior authorization determinations.

Key Responsibilities:

• Review and evaluate all prior authorization requests in accordance with clinical guidelines, policies, and plan design.

• Communicate coverage determinations clearly and efficiently to healthcare providers, employers, patients, and health plans.

• Collaborate with technicians and team members to facilitate and expedite prior authorization processing.

• Conduct and handle inbound/outbound clinical calls with providers, team members, and patients as needed.

• Ensure adherence to service level agreements and maintain accurate documentation.

• Stay current on drug and disease states relevant to specialty and non-specialty pharmacy programs.

• Participate in meetings, trainings, and on-call/after-hours support as required.

Qualifications:

• Must have an active Pharmacist license in the state of North Carolina (required on resume).

• Minimum High School Diploma or GED required (verifiable).

• Smartphone required (for VPN token installation).

• Must include internet speed test from on resume (minimum 25 Mbps download / 3 Mbps upload).

Work from Home Requirements:

• Reliable high-speed broadband internet connection (minimum 25 Mbps down / 3 Mbps up).

• Private, secure, and dedicated workspace used solely for business during work hours.

• Compliance with Privacy Practices and data security standards:

  • Confidential materials/screens must be protected from unauthorized access/viewing.

  • Devices must be locked or shut down when unattended.

• Must be in a stable living situation and available for potential future on-site reassignment if required.

Additional Information:

• Candidate must be self-motivated , detail-oriented, and capable of working independently in a remote setting.

• Strong communication and decision-making skills are essential.

• Must be comfortable with electronic documentation, virtual communication tools, and clinical systems.

To Apply:
Please ensure your resume includes:

• Active NC license number

• Internet speed test (via with provider name and connection speeds

Job Tags

Similar Jobs