Pharmacist, Advisor
- Hiring from
- United States
- Work type
- Remote
- Posted
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It takes great medical minds to create powerful solutions that solve some of healthcare’s most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you’ve honed your career in a fast-moving medical environment. While Gainwell operates with a sense of urgency, you’ll have the opportunity to work more flexible hours. And working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values work-life balance, continuous learning, and career development.
Summary
As a Prior Authorization Pharmacist, you will review clinical documentation and Preferred Drug List criteria to determine the appropriateness of medication therapy and prior authorization requests. You will collaborate with internal and external stakeholders to evaluate and continuously improve utilization management strategies, clinical programs, and pharmacy operations.
Your role in our mission
- Conduct clinical evaluations of medication therapy and review prior authorization requests using established clinical guidelines and Preferred Drug List criteria.
- Participate in peer-to-peer discussions with medical providers regarding prior authorization reviews, clinical determinations, and appropriate medication therapy.
- Provide clinical pharmacy consultations and interventions, including reviewing prior authorization data to identify prescribing trends and opportunities for intervention.
- Support Clinical Call Center and Prior Authorization operations by providing pharmacy expertise and assisting with communications to members, providers, and internal teams.
- Collaborate with Medical Directors, Clinical Pharmacists, Clinical Specialty Pharmacists, and other stakeholders to maintain clinical integrity and advance pharmacy program best practices.
- Identify and support quality and operational improvements that enhance the efficiency and effectiveness of pharmacy programs and services.
What we're looking for
- Doctor of Pharmacy (PharmD) or Bachelor of Science in Pharmacy with relevant specialty experience.
- Active, unrestricted pharmacist license in the applicable state.
- At least four years of clinical pharmacy experience, including clinical reviews using recognized drug compendia, clinical guidelines, and clinical trial data.
- Strong analytical, research, communication, and problem-solving skills, with the ability to translate clinical findings into practical recommendations.
- Strong collaboration and team skills, with proficiency in Microsoft Office and the ability to quickly learn proprietary systems.
What you should expect in this role
- This position is remote.
- Work hours: Eastern Time Zone
- The deadline to submit applications for this posting is December 31, 2026.
The pay range for this position is 90,900 - 129,900 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. Put your passion to work at Gainwell. You’ll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits, and educational assistance. We also have a variety of leadership and technical development academies to help build your skills and capabilities.
We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Build your career with Gainwell, an industry leader. You’ll be joining a company where collaboration, innovation, and inclusion fuel our growth. Learn more about Gainwell at our company website and visit our Careers site for all available job role openings.
Gainwell Technologies is an Equal Opportunity Employer, where all qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical condition), age, sexual orientation, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. Gainwell Technologies defines “wages” and “wage rates” to include “all forms of pay, including, but not limited to, salary, overtime pay, bonuses, stock, stock options, profit sharing and bonus plans, life insurance, vacation and holiday pay, cleaning or gasoline allowances, hotel accommodations, reimbursement for travel expenses, and benefits.
