Remote Prior Authorization Pharmacist

Denham Springs, LA - USA

Monthly Salary: Not Disclosed

Posted on: 16-10-2025

Vacancies: 1 Vacancy

Job Summary

Remote Prior Authorization Pharmacist Work From Home in Managed Care

A confidential managed care organization is seeking a motivated Remote Prior Authorization Pharmacist to evaluate prescription requests ensure medical necessity and improve patient access to safe and effective therapies. This work-from-home position is ideal for pharmacists who want to transition out of retail or hospital settings while building expertise in managed care.

Key Responsibilities

Review prior authorization requests for accuracy appropriateness and clinical necessity.
Apply plan criteria evidence-based guidelines and regulatory standards to determinations.
Communicate approval/denial decisions clearly to providers and patients.
Collaborate with physicians nurses and medical directors on complex cases.
Document outcomes in compliance with health plan policies and CMS/state regulations.
Support process improvements to streamline workflow and turnaround times.

What Youll Bring

Education: Doctor of Pharmacy (PharmD) or Bachelor of Pharmacy degree.
Licensure: Active and unrestricted pharmacist license in the U.S.
Experience: Prior authorization utilization management or managed care preferred retail or hospital pharmacists with strong clinical judgment are encouraged to apply.
Skills: Excellent clinical review documentation and communication skills.

Why This Role

Flexibility: 100% remote work from home with flexible scheduling options.
Impact: Directly influence patient access to safe and cost-effective medications.
Growth: Build specialized skills in utilization management and managed care.
Rewards: Competitive compensation benefits and career advancement opportunities.

About Us
We are a confidential healthcare partner working with health plans and PBMs across the U.S.. Our pharmacists ensure patients receive the right therapy at the right time while maintaining compliance with all regulations.

Apply Today
Take the next step in your career with our Remote Prior Authorization Pharmacist opportunity and enjoy the benefits of working from home while shaping the future of managed care.

Remote Prior Authorization Pharmacist Work From Home in Managed CareA confidential managed care organization is seeking a motivated Remote Prior Authorization Pharmacist to evaluate prescription requests ensure medical necessity and improve patient access to safe and effective therapies. This work-...

Review prior authorization requests for accuracy appropriateness and clinical necessity.
Apply plan criteria evidence-based guidelines and regulatory standards to determinations.
Communicate approval/denial decisions clearly to providers and patients.
Collaborate with physicians nurses and medical directors on complex cases.
Document outcomes in compliance with health plan policies and CMS/state regulations.
Support process improvements to streamline workflow and turnaround times.

What Youll Bring

Education: Doctor of Pharmacy (PharmD) or Bachelor of Pharmacy degree.
Licensure: Active and unrestricted pharmacist license in the U.S.
Experience: Prior authorization utilization management or managed care preferred retail or hospital pharmacists with strong clinical judgment are encouraged to apply.
Skills: Excellent clinical review documentation and communication skills.

Why This Role

Flexibility: 100% remote work from home with flexible scheduling options.
Impact: Directly influence patient access to safe and cost-effective medications.
Growth: Build specialized skills in utilization management and managed care.
Rewards: Competitive compensation benefits and career advancement opportunities.