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Remote Clinical Pharmacist - Commercial Utilization Management Job Description This remote Clinical Pharmacist role focuses on reviewing Commercial members' Utilization Management requests, including formulary exceptions, prior authorizations, step therapy, and quantity limit exceptions. You will apply clinical judgment to evaluate coverage determinations using client-specific criteria, document clear decisions, and communicate effectively with healthcare providers and team members. The position offers an opportunity to move away from retail pharmacy, work independently in a structured environment, and potentially expand into specialized case review and other clinical programs over time. Responsibilities Review and complete Commercial Utilization Management requests such as prior authorizations, formulary exceptions, step therapy, quantity limit exceptions, and tier exceptions with a high level of accuracy and attention to detail. Evaluate coverage determination requests using client-specific, pre-approved clinical criteria, ensuring that approval or denial decisions align with the clinical content of each case and the intent of the criteria. Draft and apply appropriate denial language that accurately reflects the clinical reasoning and supports clear, compliant communication to members and prescribers. Use sound clinical judgment to assess complex medication regimens and therapy plans, making independent decisions while leveraging available resources and guidelines. Provide direct consultation to healthcare providers and members regarding non-formulary medications and other clinical product coverage issues, offering clear and professional explanations. Collaborate closely with other pharmacists, supervisors, technicians, and team members to promote consistency of decisions and maintain alignment on clinical standards across the pharmacist team. Participate in routine touchpoints, including training sessions, team meetings, and one-on-one discussions via video calls and messaging platforms, to stay informed and engaged with team goals. Meet established productivity expectations by completing cases efficiently and maintaining throughput consistent with team averages. Maintain a quality score of at least 95% by ensuring decisions and documentation are accurate, complete, and compliant with policies and clinical criteria. Demonstrate strong accountability through reliable attendance, timely communication, and adherence to scheduling and overtime requirements, especially during peak season. Adapt to feedback from supervisors and senior pharmacists, continuously improving clinical decision-making, problem-solving, and workflow efficiency. Quickly learn and effectively use multiple computer systems, platforms, and tools, including Microsoft Word, Excel, AutoHotkey, and multi-monitor setups, to manage and process cases. Participate in training programs that include instructor-led sessions, videos, worksheets, and practice cases, and apply learned concepts to production work. Maintain flexibility to take on additional responsibilities as assigned, which may include cross-training for specialized case review (such as oncology or hepatitis C) or other departments like Medication Therapy Management or Call Center Counseling, as business needs allow. Support a positive team culture by being receptive to feedback, demonstrating learning agility, and contributing to a collaborative, team-oriented environment. Essential Skills Doctor of Pharmacy (PharmD) or Bachelor of Science in Pharmacy degree. Current pharmacist license in good standing with a State Board of Pharmacy in the state where the position is located or as required, with full transparency regarding any disciplinary actions on the license. Current active Tennessee pharmacist license in good standing. Entry-level, will consider all levels of experience. Demonstrated ability to make independent clinical decisions and apply clinical judgment to complex medication and coverage scenarios. Strong ability to prioritize tasks and manage multiple cases and projects simultaneously in a fast-paced, metrics-driven environment. Results-oriented mindset with a drive to deliver high-quality work efficiently and consistently. Self-motivated and able to work independently without constant direction or feedback while maintaining high performance standards. Comfort and proficiency with learning new computer systems and navigating multiple platforms at once. Basic IT troubleshooting skills and the ability to work effectively with multi-monitor setups. Proficiency with Microsoft Word and Excel for documentation, case review, and reporting. Ability to type at least 45 words per minute to manage documentation and system navigation efficiently. Excellent written and verbal communication skills for interacting with healthcare providers, members, and internal team members. High level of attention to detail and accuracy, supporting a quality score of at least 95% on case reviews. Flexibility and resourcefulness in adapting to changing business needs, schedules, and workload demands. Additional Skills & Qualifications Experience in retail pharmacy, clinical pharmacy, or managed care pharmacy, including exposure to prior authorization and utilization management processes. Background or familiarity with Pharmacy Benefit Management (PBM), with prior PBM experience considered but not required. Experience with compounding pharmacy practices is beneficial. Comfort working with medication coverage issues, including non-formulary requests, step therapy protocols, and quantity limit exceptions. Ability to quickly learn and use productivity tools such as AutoHotkey to streamline workflow and case processing. Strong problem-solving skills, learning agility, and the ability to integrate feedback into improved clinical and operational performance. Demonstrated ability to work both independently and collaboratively, maintaining a team-player attitude while managing individual responsibilities. Interest in expanding clinical expertise through potential training on specialized cases, such as oncology, hepatitis C, and other complex conditions, as opportunities arise. Openness to cross-training in other departments, including Medication Therapy Management (MTM) and Call Center Counseling (CCC), when business needs and performance metrics support additional training. Consistent track record of strong attendance and reliability in previous roles, supporting the accountability expectations of a remote position. Work Environment This position is fully remote and work-from-home, offering an excellent opportunity for pharmacists seeking to transition away from traditional retail settings. Roles can be based in most U.S. states, with the exception of certain locations where residency is not permitted for this position. Licensure can be held in any U.S. state, provided it is in good standing and not from a U.S. territory. The work environment is primarily independent, supported by routine structured touchpoints and regular communication with supervisors, senior pharmacists, technicians, and other team members via messaging platforms, phone calls, and video meetings. Cameras and video calls are used for training sessions, team meetings, and one-on-one discussions with supervisors, creating a connected and collaborative remote culture. Training spans the first nine weeks and follows a Monday through Friday schedule from 8:00 a.m. to 4:30 p.m. CST. Training includes instructor-led sessions, videos, worksheets, and practice cases, with minimal time off allowed during this period due to class size and training structure. After training, newer contractors typically start between 9:00 a.m. and 9:30 a.m. CST for a regular 8-hour shift, with end times as late as 6:00 p.m. CST / 7:00 p.m. EST. Based on business needs, you may be required to work as late as 6:30 p.m. CST / 7:30 p.m. EST. Shifts are determined by a team bid process based on seniority, and schedules and hours are subject to change as business needs evolve. The role requires a full-time schedule, and overtime may be necessary during busy periods, particularly during peak season, which typically runs from November through May. The team rotates weekend shifts and shares holiday coverage, with pharmacists generally working every seventh weekend, and peak season may increase the frequency of weekend rotations. Future holiday assignments are determined through a team bid process and seniority. Contractors begin with a bank of unpaid time off per year, and time off is bid annually and allocated based on seniority. Any time off requested after the training period should be discussed during the interview for consideration during the initial contract term. You will work with multiple computer systems and platforms, using multi-monitor setups to manage cases efficiently. The environment emphasizes productivity, accuracy, and accountability, supported by accessible senior pharmacists who are available throughout the day to answer clinical questions and provide guidance. The culture values receptiveness to feedback, focus, problem-solving, learning agility, and a collaborative team-player attitude, making it a supportive setting for long-term professional growth. Over time, there may be opportunities, based on performance and business needs, to receive additional training for specialized case review or to be cross-trained in other clinical departments. After conversion to a permanent role, employees receive a generous vacation allowance and a comprehensive benefits package, contributing to an attractive and sustainable long-term work environment. Job Type & Location This is a Contract position based out of Eagan, MN. Pay and Benefits The pay range for this position is $55.00 - $55.00/hr. Individual compensation offered for this position within this range will depend on many factors, including qualifications, skills, relevant experience, job knowledge, geographic location, internal equity, and other pertinent job-related factors. Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following:

• Medical, dental & vision
• Critical Illness, Accident, and Hospital
• 401(k) Retirement Plan - Pre-tax and Roth post-tax contributions available
• Life Insurance (Voluntary Life & AD&D for the employee and dependents)
• Short and long-term disability
• Health Spending Account (HSA)
• Transportation benefits
• Employee Assistance Program
• Time Off/Leave (PTO, Vacation or Sick Leave) Workplace Type This is a fully remote position.

Application Deadline This position is anticipated to close on Sep 25, 2026. About Actalent Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 20,000 consultants and 5,000 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500. We are proud to be an Engineering News-Record (ENR) Top 500 Design Firm for our engineering design services and a ClearlyRated Best of Staffing® winner for both client and talent service. The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law. If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please email actalentaccommodation@actalentservices.com for other accommodation options.

San Francisco Fair Chance Ordinance:

Pursuant to the San Francisco Fair Chance Ordinance, for all positions located in the city and county of San Francisco, we will consider for employment qualified applicants with arrest and conviction records.

Massachusetts Lie Detector:

It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability. Use of Artificial Intelligence (AI): We may use Artificial Intelligence (AI) to support parts of our hiring process, including sourcing, screening, and evaluating candidates. AI helps assess applications and qualifications, but final decisions are made by our hiring team. By applying, you acknowledge and agree that your application may be reviewed using AI tools.