Pharmacist - Remote

Job Title: Remote Clinical Pharmacist (Appeals & Prior Authorization) Location: Remote Schedule : Monday through Friday, 9:00 AM to 6:00 PM EST Position Overview We are seeking licensed Clinical Pharmacists to join a growing Pharmacy Appeals and Prior Authorization team. This role is responsible for evaluating pharmacy coverage determinations, redeterminations, and appeals while ensuring compliance with clinical guidelines, regulatory requirements, and benefit plan provisions. The ideal candidate is self-motivated, detail-oriented, and able to manage a high-volume caseload in a fast-paced remote environment. This team offers a collaborative and supportive culture focused on learning, professional development, and delivering quality clinical outcomes. Key Responsibilities Review prior authorization and pharmacy appeals requests for medical necessity, appropriateness, and benefit coverage. Evaluate chart notes, laboratory results, prescription history, and supporting clinical documentation. Apply clinical criteria, medical policies, and evidence-based guidelines to make coverage determinations. Assess formulary and non-formulary medication requests using sound clinical judgment. Research and provide drug information using clinical resources and references. Verify member eligibility, prescription benefits, and prior authorization history. Support data collection, reporting, formulary management activities, and utilization review initiatives. Collaborate with pharmacy technicians, pharmacists, and cross-functional teams to ensure timely case resolution. Maintain compliance with state and federal pharmacy regulations and organizational policies. Qualifications: (Required) Doctor of Pharmacy (PharmD) degree. Active Pharmacist (RPh) license in good standing in any U.S. state. Experience in managed care, prior authorization, appeals, or utilization management. Understanding of Medicare and Medicaid regulations. Job Type & Location This is a Contract position based out of Austin, TX. Pay and Benefits The pay range for this position is $60.00 - $65.00/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 Sep 9, 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 [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.