Clinical Pharmacist - Medicare / Prior Auth

Remote Full-time
Job Title: Clinical Pharmacist - Medicare / Prior Auth Location: 100% Remote Contract: 6 month+ (Possibilities of Extension) Shift: 7 AM–8 PM EST (rotational schedule) Pay Range: $50 - $55/hr. on W2 Position Overview: We’re seeking a detail-oriented and clinically driven Clinical Pharmacist Advisor to support Medicare and Prior Authorization operations. In this role, you’ll review, analyze, and process pharmacy benefit requests while ensuring compliance with regulatory and clinical standards. This position requires precision, professionalism, and a commitment to improving patient outcomes—all from the comfort of your home. Key Responsibilities: • Review and process Medicare Part D pharmacy benefit requests efficiently and accurately. • Evaluate clinical information and apply sound clinical judgment based on established criteria and guidelines. • Interpret internal notes, documentation, and fax requests to confirm complete and compliant case setup. • Conduct outreach to providers, members, and pharmacies as needed to obtain additional clinical data. • Make evidence-based determinations using Medicare compendia and formulary policies. • Ensure all work aligns with HIPAA regulations, CMS guidelines, and organizational standards. Job Title: Clinical Pharmacist - Medicare / Prior Auth Location: 100% Remote Contract: 6 month+ (Possibilities of Extension) Shift: 7 AM–8 PM EST (rotational schedule) Pay Range: $50 - $55/hr. on W2 Position Overview: We’re seeking a detail-oriented and clinically driven Clinical Pharmacist Advisor to support Medicare and Prior Authorization operations. In this role, you’ll review, analyze, and process pharmacy benefit requests while ensuring compliance with regulatory and clinical standards. This position requires precision, professionalism, and a commitment to improving patient outcomes—all from the comfort of your home. Key Responsibilities: • Review and process Medicare Part D pharmacy benefit requests efficiently and accurately. • Evaluate clinical information and apply sound clinical judgment based on established criteria and guidelines. • Interpret internal notes, documentation, and fax requests to confirm complete and compliant case setup. • Conduct outreach to providers, members, and pharmacies as needed to obtain additional clinical data. • Make evidence-based determinations using Medicare compendia and formulary policies. • Ensure all work aligns with HIPAA regulations, CMS guidelines, and organizational standards. Apply tot his job
Apply Now →

Similar Jobs

Experienced Remote Data Entry Clerk and Typing Specialist for Full-Time or Part-Time Opportunities with Unlimited Growth Potential at blithequark

Remote Full-time

Experienced Customer Service Representative – Remote Part-Time Live Chat Support Specialist for E-commerce Platform

Remote Full-time

Experienced Remote Chat Support Agent – Public Relations and Customer Service Expertise for blithequark

Remote Full-time

Pharmacy Specialist, Pain Management (Pharmacist 5) – Pharmacy Inpatient in Sacramento, CA

Remote Full-time

Experienced Remote Administrative Assistant – Full/Part Time Data Entry and Customer Service Representative for Blithequark

Remote Full-time

Experienced Remote Data Entry Specialist – Full-Time Opportunity for Detail-Oriented Professionals to Join blithequark's Dynamic Team

Remote Full-time

Experienced Remote Customer Support Specialist – Technical Troubleshooting and Customer Service Expert for blithequark

Remote Full-time

Experienced Remote Customer Support Agent – Delivering Unparalleled Travel Experiences and Exceptional Client Service

Remote Full-time

Experienced Technical Customer Support Specialist for Hospitality SaaS and Smart Home Devices – Remote Troubleshooting and Installation Support

Remote Full-time

Experienced Part-Time Data Entry Clerk for Remote Work Opportunities in Market Research and Administration

Remote Full-time

Remote Part-Time Data Entry Specialist - Work from Home with Walmart's Dynamic Team

Remote Full-time

[Remote] Grand Welcome, CFO

Remote Full-time

Experienced Remote Chat Support Specialist - No Phone Calls Required - Earn $25-$35/hr with blithequark

Remote Full-time

**Experienced Full Stack Sales Support and Services Manager – Disney Customer Support Remote Jobs**

Remote Full-time

Experienced Junior Business Data Analyst – Remote Opportunity for Data-Driven Decision Making

Remote Full-time

Experienced Virtual Chat Operator – Delivering Exceptional Customer Service through Remote and In-Office Support

Remote Full-time

Remote Travel Planner & Client Experience Specialist – Flexible Full‑Time/Part‑Time Role with Global Travel Agency

Remote Full-time

Experienced Part-Time Online Data Entry Specialist – Remote Work Opportunity for Detail-Oriented Individuals

Remote Full-time

Remote Entry‑Level Data Entry Specialist – Netflix Content & Analytics Team – Flexible Hours, Competitive Pay, Work‑from‑Home Opportunity

Remote Full-time

Senior Lead Generation Specialist

Remote Full-time
← Back to Home