Pharmacist Operations Advisor

Job Title: Pharmacist – Prior Authorization
Job Type: Full-Time
Schedule:

• Training: Monday–Friday, 8:00 AM–4:30 PM CT (7 weeks)

• Production: Sunday–Thursday or Tuesday–Saturday (shifts between 10:30 AM–8:00 PM CT)
  Location: Remote

Job Summary:

Seeking a licensed Pharmacist to join a clinical prior authorization team. This role focuses on evaluating prior authorization requests, applying clinical criteria and plan guidelines, and communicating timely decisions to healthcare providers, patients, and internal teams.

Key Responsibilities:

• Review and process prior authorization requests based on clinical and plan-specific criteria

• Communicate determinations to physicians, patients, and other stakeholders

• Collaborate with team members to resolve cases and ensure timely processing

• Handle clinical phone inquiries and escalate cases as needed

• Maintain current knowledge of medications, disease states, and pharmacy guidelines

• Participate in training, team meetings, and on-call support as needed

Qualifications:

• Active Registered Pharmacist license

• Bachelor’s in Pharmacy (PharmD preferred)

• 1–3 years of experience (PBM or prior authorization experience required)

• Proficient in Microsoft Excel and Word

• Strong multitasking, communication, and decision-making skills

• Ability to protect patient confidentiality and follow all regulatory requirements