A managed care and pharmacy benefits organisationHiring

Clinical Pharmacist

  • USD 84,800 to 99,376 per year
  • Remote, United States
  • Mid-level
  • Posted 5 days ago
In one line

Pharmacist reviewing prior authorization requests against clinical criteria, approving or denying with clear documentation; office or home office, with some travel.

About the role

Reviews are evidence-based and must hold up to regulatory standards, with timely access for patients as the goal. Documentation, communication and quality checks are part of the daily work.

At a glance

Pay
USD 84,800 to 99,376 per year
Remote scope
Remote, United States
Seniority
Mid-level
Skills
HIPAA, Prior authorization, Microsoft Office, UpToDate, Lexicomp
Posted
24 Oct 2026
Last checked
28 Oct 2026

What you will do

  • Review and process medication prior authorization requests using clinical guidelines and criteria
  • Check submitted diagnosis, labs and prior therapies for completeness
  • Approve or deny requests on clinical evidence and write the rationale clearly
  • Talk with providers about outcomes, missing information and clarifications
  • Escalate complex or medical exception cases under set protocols and take part in quality checks

What they look for

  • Doctor of Pharmacy, or a BS in Pharmacy with equivalent experience
  • At least 2 years in a PBM or health plan, with current prior authorization review experience in managed care

Benefits

  • Salary $84,800 to $99,376

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Questions about this job

Is this job fully remote, and from where?

Yes, it is listed as remote, aimed at candidates in the United States.

What does this job pay?

The posting states USD 84,800 to 99,376 per year.

What experience is needed?

It is a mid-level role. The posting asks for: doctor of Pharmacy, or a BS in Pharmacy with equivalent experience; at least 2 years in a PBM or health plan, with current prior authorization review experience in managed care. Skills it names include HIPAA, Prior authorization, Microsoft Office, UpToDate.

How do I apply with Keywordise AI?

Click Apply with Keywordise AI, create an account and upload your CV. Your CV and cover letter are written for this job from what you have really done, then Keywordise applies for you. Trial: 7 days, no card.

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