Fully Remote Clinical Review Pharmacist
Well-Known PBM | Offers Benefits | Fully Remote | Pay: $55/hr.
Job Description
As a Pharmacist, you will be responsible for reviewing Medicaid members' Utilization Management requests, including formulary exceptions, prior authorization, step therapy, and quantity limit exceptions. You will apply clinical judgment and communicate effectively with providers to determine the approval or denial of prior authorizations based on client-specific criteria. This role requires attention to detail and regular communication with providers and team members.
Responsibilities
Review and process Medicaid members' Utilization Management requests.
Apply clinical judgment to determine authorization approvals or denials.
Engage in regular communication with providers.
Participate in monthly video calls with supervisors.
Collaborate with coworkers, technicians, and High level pharmacists throughout the day.
Additional Skills & Qualifications
Doctor of Pharmacy (PharmD) or Bachelor of Science Pharmacy degree.
Current pharmacist license in good standing with the State Board of Pharmacy.
Two years of experience in retail, managed care, or clinical pharmacy.
Work Environment
This is a fully remote, work-from-home position available in any state except California, Hawaii, or Virginia. The role requires availability during core business hours, Monday through Friday from 7am to 11pm ET, and Saturday-Sunday from 7am to 6pm ET. Weekend shifts rotate and typically occur every fourth weekend outside of peak season. Training occurs during the first four weeks with no time off permitted. Candidates must be able to adapt to changing schedules and business needs. After conversion to a permanent employee, you will receive five weeks of vacation and a comprehensive benefits package.
Job Type & Location
This is a Contract position based out of New York, NY.
Pay and Benefits
The pay range for this position is $55.00 - $55.00/hr.
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 Jun 1, 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 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500.
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 [email protected] 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.
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