Remote Pharmacist

Overview

In our renowned Fortune 500 client company, you'll find better schedules than retail and more reach than any hospital. You'll open doors for yourself that simply do not exist in any other organization, anywhere. Take this opportunity to catapult your pharmaceutical career

As a Pharmacist, you will work in a corporate call center-based business environment where strict work guidelines are employed. You will be responsible for evaluating Prior Authorization cases and rendering coverage determinations based on clinical criteria and plan design in a fast paced and dynamic environment.

Job Responsibilities:

• Clinical Support and Decision-Making: Serve as a clinical resource working from a computer, reviewing prior authorizations and receiving phone calls from prior authorization pharmacy technicians and/or healthcare providers to gather, clarify, and assess detailed clinical information. Interpret medical and pharmacy policy criteria to make sound and timely coverage determinations in accordance with federal, state, and organizational guidelines.
• Coverage Determination and Consultation: Consult directly with prescribing physicians and healthcare providers to clarify clinical questions, interpret guideline criteria, and provide decisions on prior authorization requests. Ensure determinations are clinically sound, evidence-based, and compliant with applicable regulations and payer policies.
• Medication Utilization Review: Collaborate with pharmacy technicians and/or prescribers to provide clinical insights on appropriate medication usage. Recommend cost-effective, formulary-compliant therapeutic alternatives when applicable, supporting optimal patient care and medication access.
• Regulatory and Policy Compliance: Maintain full compliance with state and federal pharmacy laws, Medicare Part D, Medicaid, and commercial benefit regulations. Accurately document case decisions in accordance with internal protocols, auditing standards, and confidentiality policies.
• Case Review and Clinical Assessment: Apply critical thinking and advanced clinical judgment to gather and evaluate complex medical and pharmacy data. Use established clinical guidelines, benefit policies, and drug utilization criteria to make consistent and accurate coverage determinations within required timeframes.
• Workload and Time Management: Effectively manage case volume by organizing workload, setting daily priorities, and meeting productivity and quality benchmarks. Adapt to fluctuating demands while maintaining accuracy and professionalism under pressure.
• Team Collaboration and Communication: Demonstrate excellent interpersonal and communication skills when collaborating with team members, internal departments (e.g., compliance, quality assurance), and external providers. Foster a cooperative work environment through timely and respectful communication.
• Customer Service and Conflict Resolution: Respond promptly and professionally to inquiries or concerns from providers, pharmacy staff, or internal teams. Investigate and resolve escalated issues or complaints with a service-first mindset, maintaining a positive and solutions-oriented approach.
• Quality Assurance and Continuous Improvement: Adhere to departmental quality assurance and improvement protocols by participating in audits, process evaluations, and training initiatives. Support continuous quality and service enhancements through feedback and collaboration.
• Professionalism and Team Culture: Consistently model a positive, professional image of our Rx. Demonstrate reliability, flexibility, and dedication to fostering a team-oriented environment with mutual respect and strong rapport across all departments.

Ideal candidate profile:

• Pharmacists: Bachelors or Doctorate of Pharmacy; Active State Pharmacist License
• Proficiency with Microsoft Excel (ability to create, edit, and save a basic spreadsheet), Microsoft Word, and Microsoft Outlook.
• Professional proficiency in English
• Candidate must also have a secure workspace/office in their home.
• Ability to work 40 hours/week during standard business operating hours Monday - Friday from 9:00am - 6:00pm (It may be necessary, given the business need, to work occasional overtime on weekends and holidays)

This is a contract assignment. Please apply to learn more

TPIS is an Equal Opportunity Employer (EEO Employer / Affirmative Action for Females / Disabled / Veterans). We comply with all Federal, State and Local laws regarding nondiscrimination.

Job Types: Full-time, Contract

Pay: $108,160.00 per year

Benefits:

• Professional development assistance

Work Location: Remote