Location:

Remote (licensed pharmacists from any state are eligible)

Schedule:

Monday to Friday, 12:00 PM - 8:30 PM EST Mandatory weekend and holiday rotation No days off except emergencies from 01/01/2027 to 03/31/2027

Responsibilities:

Review Part B drug and biologic prior authorization requests and appeals Apply clinical policies, utilization management criteria, and Medicare requirements to authorization decisions Provide support and guidance to clinical and non-clinical internal teams on Part B drug policies and workflows Identify opportunities to improve review quality, accuracy, and operational efficiency Adapt to a fast-paced environment with evolving workflows and business needs Maintain consistent quality and manage changing priorities and volumes

Qualifications:

PharmD degree with active pharmacist licensure in at least one state Minimum 2 years of utilization management experience, managed care residency, or relevant specialty pharmacy expertise Demonstrated strong clinical judgment with the ability to independently evaluate complex Part B drug requests Experience with Medicare Part B drug prior authorization and appeals review preferred Prior utilization management and prior authorization experience highly valued

Additional Information:

The role is a 6-month contract from October 1, 2026, to March 31, 2027, with temp-to-hire potential All necessary equipment will be provided This role is ideal for pharmacists with a background in Medicare Part B utilization management seeking a challenging position with a highly respected healthcare organization. Candidates with direct Medicare Part B, utilization management, or prior authorization experience are strongly encouraged to apply. to advance your career in pharmacy management and join a dynamic, evolving team. Compensation for this position ranges from $52.00 to $72.00. Eligible candidates may also receive healthcare benefits, housing, and meals/incidentals. Full details of our healthcare benefits plan can be found . This posting is open for 60 days after the posting date. 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