Pharmacist (100%, CTH, PBM)

Clinical Pharmacist

100% Remote | Specialty Medications | Offers Benefits

Job Description

This fully remote Clinical Pharmacist role focuses on utilization management for specialty medications, with a strong emphasis on oncology and other complex therapeutic areas. You will perform detailed clinical reviews of coverage determination requests, including prior authorizations, formulary exceptions, step therapy, and quantity limit exceptions across Commercial, Medicare (non-claims), and Medicaid lines of business. The position offers an opportunity to transition away from retail pharmacy into a highly clinical, data-driven environment, with the potential for long-term conversion to a permanent role and a comprehensive benefits and vacation package after conversion.

Responsibilities

• Review and complete clinical evaluations for coverage determination requests related to prior authorization and other utilization management programs, including formulary exceptions, step therapy, and quantity limit exceptions.
• Assess specialty medications, primarily injectables and infused therapies, across oncology (approximately 60%) and other specialties such as rheumatology, gastroenterology, neurology, and dermatology.
• Apply client-specific clinical criteria and evidence-based guidelines to determine whether prior authorization requests meet coverage requirements.
• Exercise sound clinical judgment when evaluating complex and often uncommon or cutting-edge therapies spanning approximately 500 specialty medications.
• Document clinical rationales clearly and accurately in the appropriate systems to support coverage determinations and downstream processes.
• Consult directly with health care providers via inbound and outbound calls to discuss non-formulary and clinical product coverage issues and clarify clinical information when needed.
• Collaborate with fellow pharmacists, senior pharmacists, technicians, and other team members to promote consistency in clinical decisions and adherence to established criteria.
• Engage in regular communication with supervisors and team members through messaging platforms, phone calls, and video meetings for training, team meetings, and one-on-one discussions.
• Utilize multiple computer systems and platforms simultaneously, including Microsoft applications and AutoHotkey, to manage cases efficiently and accurately.
• Maintain productivity by completing an average of approximately 30 cases per day while upholding high standards of accuracy and clinical quality.
• Demonstrate strong attendance, accountability, and professional communication in all interactions with internal and external stakeholders.
• Adapt to feedback, process changes, and evolving clinical criteria while maintaining focus, problem-solving skills, and learning agility.
• Work independently in a remote environment while actively contributing to a collaborative, team-oriented culture.
• Participate in extensive initial training, including instructor-led sessions, videos, worksheets, and practice case reviews, and begin handling live cases by the third or fourth week of training.
• Perform other related duties as assigned to support the overall goals of the utilization management team.

Essential Skills

• Doctor of Pharmacy (PharmD) or Bachelor of Science in Pharmacy degree.
• Current pharmacist license in good standing with a U.S. State Board of Pharmacy in the state where the candidate is licensed.
• Five (5) or more years of work experience as a pharmacist in retail, managed care, or clinical pharmacy settings

Job Type & Location

This is a Contract position based out of Eagan, MN.

Pay and Benefits

The pay range for this position is $55.00 - $55.00/hr.

Individual compensation offered for this position within this range will depend on many factors, including qualifications, skills, relevant experience, job knowledge, geographic location, internal equity, and other pertinent job-related factors.

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 Oct 8, 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 20,000 consultants and 5,000 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500. We are proud to be an Engineering News-Record (ENR) Top 500 Design Firm for our engineering design services and a ClearlyRated Best of Staffing® winner for both client and talent service.

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 actalentaccommodation@actalentservices.com 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.