Clinical Pharmacist Advisor - Medicare Part D (REMOTE)
Job Description
Clinical Pharmacist Advisor - Medicare Part D (REMOTE)
Location: 100% Remote (U.S.)
Pay Rate: $53.00/hr
Schedule: Set rotation within business hours (see below)
Opportunity: Contract with potential for full-time conversion
About the Role
We are hiring 50 Remote Clinical Pharmacist Advisors to support Medicare Part D members and providers in a fast-paced, high-volume, production-driven environment. This role is ideal for pharmacists with prior authorization, managed care, or PBM experience who thrive in a structured, remote setting.
As a Clinical Pharmacist Advisor, you will review pharmacy benefit requests, make clinical determinations, and ensure compliance with CMS and Medicare guidelines while delivering best-in-class service.
Key Responsibilities
• Review and process prior authorizations, coverage determinations, and appeals
• Evaluate clinical documentation to support approval/denial decisions
• Ensure all cases meet Medicare Part D and CMS compliance standards
• Conduct provider outreach to obtain additional clinical information
• Document all decisions clearly and accurately in system workflows
• Manage high-volume queues while meeting productivity and quality metrics
• Apply clinical knowledge using drug compendia and established guidelines
Required Qualifications
• Active Pharmacist license in state of residence (in good standing)
• PharmD or Bachelor's Degree in Pharmacy
• Strong computer skills (Excel, Word required; Access, PowerPoint, Visio preferred)
• Experience with data entry, dual screens, and multiple systems
• Ability to work independently in a productivity-driven remote environment
• Strong attention to detail and documentation accuracy
Preferred Experience
• Managed Care / PBM experience
• Prior Authorization, Coverage Determinations, or Appeals
• Medicare Part D knowledge and CMS guideline familiarity
• Remote pharmacist or high-volume review experience
• Retail + Managed Care hybrid background
Schedule & Training Requirements
• Training: Monday-Friday, 9:00 AM - 5:30 PM EST (first 8 weeks - no time off allowed)
• Post-Training Schedule:
• Business Hours: 7:00 AM - 8:00 PM EST (Mon-Fri)
• Weekends: 7:00 AM - 4:30 PM EST
• Must be flexible to work assigned 8-hour shifts, including weekends
Work Environment Requirements (MANDATORY)
• Dedicated, quiet, private workspace
• Wired internet connection:
• Minimum 25 Mbps download / 5 Mbps upload
• Speed test screenshot required (must be included on resume)
• Ability to remain on camera during training and team meetings
• Ability to sit and focus for full shift with minimal interruptions
Submission Requirements (MUST BE INCLUDED ON RESUME)
• Screenshot of internet speed test ( www.speedtest.net )
• Screenshot of active pharmacist license (showing name, state, expiration)
• Completed candidate questionnaire (see below)
Candidate Pre-Screen Questionnaire (Include with Submission)
• Are you available for full-time training (M-F, 9-5:30 EST) for 8 weeks with no time off?
• Can you work any assigned 8-hour shift between 7 AM - 8 PM EST, including weekends?
• Do you have a dedicated, quiet workspace for remote work?
• Do you have wired internet meeting 25/5 Mbps requirements?
• Can you sit and focus for the entire shift without interruptions?
• Do you have experience with data entry and multiple systems/screens?
• Do you have an active pharmacist license in your state of residence?
• Are you comfortable working independently in a productivity-based role?
• Do you bring a positive, engaged attitude to a team environment?
Job Requirements
Clinical Pharmacist Advisor - Medicare Part D (REMOTE)
Location: 100% Remote (U.S.)
Pay Rate: $53.00/hr
Schedule: Set rotation within business hours (see below)
Opportunity: Contract with potential for full-time conversion
About the Role
We are hiring 50 Remote Clinical Pharmacist Advisors to support Medicare Part D members and providers in a fast-paced, high-volume, production-driven environment. This role is ideal for pharmacists with prior authorization, managed care, or PBM experience who thrive in a structured, remote setting.
As a Clinical Pharmacist Advisor, you will review pharmacy benefit requests, make clinical determinations, and ensure compliance with CMS and Medicare guidelines while delivering best-in-class service.
Key Responsibilities
• Review and process prior authorizations, coverage determinations, and appeals
• Evaluate clinical documentation to support approval/denial decisions
• Ensure all cases meet Medicare Part D and CMS compliance standards
• Conduct provider outreach to obtain additional clinical information
• Document all decisions clearly and accurately in system workflows
• Manage high-volume queues while meeting productivity and quality metrics
• Apply clinical knowledge using drug compendia and established guidelines
Required Qualifications
• Active Pharmacist license in state of residence (in good standing)
• PharmD or Bachelor's Degree in Pharmacy
• Strong computer skills (Excel, Word required; Access, PowerPoint, Visio preferred)
• Experience with data entry, dual screens, and multiple systems
• Ability to work independently in a productivity-driven remote environment
• Strong attention to detail and documentation accuracy
Preferred Experience
• Managed Care / PBM experience
• Prior Authorization, Coverage Determinations, or Appeals
• Medicare Part D knowledge and CMS guideline familiarity
• Remote pharmacist or high-volume review experience
• Retail + Managed Care hybrid background
Schedule & Training Requirements
• Training: Monday-Friday, 9:00 AM - 5:30 PM EST (first 8 weeks - no time off allowed)
• Post-Training Schedule:
• Business Hours: 7:00 AM - 8:00 PM EST (Mon-Fri)
• Weekends: 7:00 AM - 4:30 PM EST
• Must be flexible to work assigned 8-hour shifts, including weekends
Work Environment Requirements (MANDATORY)
• Dedicated, quiet, private workspace
• Wired internet connection:
• Minimum 25 Mbps download / 5 Mbps upload
• Speed test screenshot required (must be included on resume)
• Ability to remain on camera during training and team meetings
• Ability to sit and focus for full shift with minimal interruptions
Submission Requirements (MUST BE INCLUDED ON RESUME)
• Screenshot of internet speed test ( www.speedtest.net )
• Screenshot of active pharmacist license (showing name, state, expiration)
• Completed candidate questionnaire (see below)
Candidate Pre-Screen Questionnaire (Include with Submission)
• Are you available for full-time training (M-F, 9-5:30 EST) for 8 weeks with no time off?
• Can you work any assigned 8-hour shift between 7 AM - 8 PM EST, including weekends?
• Do you have a dedicated, quiet workspace for remote work?
• Do you have wired internet meeting 25/5 Mbps requirements?
• Can you sit and focus for the entire shift without interruptions?
• Do you have experience with data entry and multiple systems/screens?
• Do you have an active pharmacist license in your state of residence?
• Are you comfortable working independently in a productivity-based role?
• Do you bring a positive, engaged attitude to a team environment?
Apply tot his job
Apply To this Job
Clinical Pharmacist Advisor - Medicare Part D (REMOTE)
Location: 100% Remote (U.S.)
Pay Rate: $53.00/hr
Schedule: Set rotation within business hours (see below)
Opportunity: Contract with potential for full-time conversion
About the Role
We are hiring 50 Remote Clinical Pharmacist Advisors to support Medicare Part D members and providers in a fast-paced, high-volume, production-driven environment. This role is ideal for pharmacists with prior authorization, managed care, or PBM experience who thrive in a structured, remote setting.
As a Clinical Pharmacist Advisor, you will review pharmacy benefit requests, make clinical determinations, and ensure compliance with CMS and Medicare guidelines while delivering best-in-class service.
Key Responsibilities
• Review and process prior authorizations, coverage determinations, and appeals
• Evaluate clinical documentation to support approval/denial decisions
• Ensure all cases meet Medicare Part D and CMS compliance standards
• Conduct provider outreach to obtain additional clinical information
• Document all decisions clearly and accurately in system workflows
• Manage high-volume queues while meeting productivity and quality metrics
• Apply clinical knowledge using drug compendia and established guidelines
Required Qualifications
• Active Pharmacist license in state of residence (in good standing)
• PharmD or Bachelor's Degree in Pharmacy
• Strong computer skills (Excel, Word required; Access, PowerPoint, Visio preferred)
• Experience with data entry, dual screens, and multiple systems
• Ability to work independently in a productivity-driven remote environment
• Strong attention to detail and documentation accuracy
Preferred Experience
• Managed Care / PBM experience
• Prior Authorization, Coverage Determinations, or Appeals
• Medicare Part D knowledge and CMS guideline familiarity
• Remote pharmacist or high-volume review experience
• Retail + Managed Care hybrid background
Schedule & Training Requirements
• Training: Monday-Friday, 9:00 AM - 5:30 PM EST (first 8 weeks - no time off allowed)
• Post-Training Schedule:
• Business Hours: 7:00 AM - 8:00 PM EST (Mon-Fri)
• Weekends: 7:00 AM - 4:30 PM EST
• Must be flexible to work assigned 8-hour shifts, including weekends
Work Environment Requirements (MANDATORY)
• Dedicated, quiet, private workspace
• Wired internet connection:
• Minimum 25 Mbps download / 5 Mbps upload
• Speed test screenshot required (must be included on resume)
• Ability to remain on camera during training and team meetings
• Ability to sit and focus for full shift with minimal interruptions
Submission Requirements (MUST BE INCLUDED ON RESUME)
• Screenshot of internet speed test ( www.speedtest.net )
• Screenshot of active pharmacist license (showing name, state, expiration)
• Completed candidate questionnaire (see below)
Candidate Pre-Screen Questionnaire (Include with Submission)
• Are you available for full-time training (M-F, 9-5:30 EST) for 8 weeks with no time off?
• Can you work any assigned 8-hour shift between 7 AM - 8 PM EST, including weekends?
• Do you have a dedicated, quiet workspace for remote work?
• Do you have wired internet meeting 25/5 Mbps requirements?
• Can you sit and focus for the entire shift without interruptions?
• Do you have experience with data entry and multiple systems/screens?
• Do you have an active pharmacist license in your state of residence?
• Are you comfortable working independently in a productivity-based role?
• Do you bring a positive, engaged attitude to a team environment?
Job Requirements
Clinical Pharmacist Advisor - Medicare Part D (REMOTE)
Location: 100% Remote (U.S.)
Pay Rate: $53.00/hr
Schedule: Set rotation within business hours (see below)
Opportunity: Contract with potential for full-time conversion
About the Role
We are hiring 50 Remote Clinical Pharmacist Advisors to support Medicare Part D members and providers in a fast-paced, high-volume, production-driven environment. This role is ideal for pharmacists with prior authorization, managed care, or PBM experience who thrive in a structured, remote setting.
As a Clinical Pharmacist Advisor, you will review pharmacy benefit requests, make clinical determinations, and ensure compliance with CMS and Medicare guidelines while delivering best-in-class service.
Key Responsibilities
• Review and process prior authorizations, coverage determinations, and appeals
• Evaluate clinical documentation to support approval/denial decisions
• Ensure all cases meet Medicare Part D and CMS compliance standards
• Conduct provider outreach to obtain additional clinical information
• Document all decisions clearly and accurately in system workflows
• Manage high-volume queues while meeting productivity and quality metrics
• Apply clinical knowledge using drug compendia and established guidelines
Required Qualifications
• Active Pharmacist license in state of residence (in good standing)
• PharmD or Bachelor's Degree in Pharmacy
• Strong computer skills (Excel, Word required; Access, PowerPoint, Visio preferred)
• Experience with data entry, dual screens, and multiple systems
• Ability to work independently in a productivity-driven remote environment
• Strong attention to detail and documentation accuracy
Preferred Experience
• Managed Care / PBM experience
• Prior Authorization, Coverage Determinations, or Appeals
• Medicare Part D knowledge and CMS guideline familiarity
• Remote pharmacist or high-volume review experience
• Retail + Managed Care hybrid background
Schedule & Training Requirements
• Training: Monday-Friday, 9:00 AM - 5:30 PM EST (first 8 weeks - no time off allowed)
• Post-Training Schedule:
• Business Hours: 7:00 AM - 8:00 PM EST (Mon-Fri)
• Weekends: 7:00 AM - 4:30 PM EST
• Must be flexible to work assigned 8-hour shifts, including weekends
Work Environment Requirements (MANDATORY)
• Dedicated, quiet, private workspace
• Wired internet connection:
• Minimum 25 Mbps download / 5 Mbps upload
• Speed test screenshot required (must be included on resume)
• Ability to remain on camera during training and team meetings
• Ability to sit and focus for full shift with minimal interruptions
Submission Requirements (MUST BE INCLUDED ON RESUME)
• Screenshot of internet speed test ( www.speedtest.net )
• Screenshot of active pharmacist license (showing name, state, expiration)
• Completed candidate questionnaire (see below)
Candidate Pre-Screen Questionnaire (Include with Submission)
• Are you available for full-time training (M-F, 9-5:30 EST) for 8 weeks with no time off?
• Can you work any assigned 8-hour shift between 7 AM - 8 PM EST, including weekends?
• Do you have a dedicated, quiet workspace for remote work?
• Do you have wired internet meeting 25/5 Mbps requirements?
• Can you sit and focus for the entire shift without interruptions?
• Do you have experience with data entry and multiple systems/screens?
• Do you have an active pharmacist license in your state of residence?
• Are you comfortable working independently in a productivity-based role?
• Do you bring a positive, engaged attitude to a team environment?
Apply tot his job
Apply To this Job