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
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