Clinical Pharmacist Advisor (Medicare Part D) – REMOTE

Clinical Pharmacist Advisor – Medicare Part D (REMOTE) Location: 100% Remote (U.S.) Pay Rate: $53.00/hr Schedule: Set rotation within business hours (see below) Opportunity: Contract with potential for full-time conversion About the Role We are hiring 50 Remote Clinical Pharmacist Advisors to support Medicare Part D members and providers in a fast-paced, high-volume, production-driven environment. This role is ideal for pharmacists with prior authorization, managed care, or PBM experience who thrive in a structured, remote setting. As a Clinical Pharmacist Advisor, you will review pharmacy benefit requests, make clinical determinations, and ensure compliance with CMS and Medicare guidelines while delivering best-in-class service. Key Responsibilities Review and process prior authorizations, coverage determinations, and appeals Evaluate clinical documentation to support approval/denial decisions Ensure all cases meet Medicare Part D and CMS compliance standards Conduct provider outreach to obtain additional clinical information Document all decisions clearly and accurately in system workflows Manage high-volume queues while meeting productivity and quality metrics Apply clinical knowledge using drug compendia and established guidelines Required Qualifications Active Pharmacist license in state of residence (in good standing) PharmD or Bachelor’s Degree in Pharmacy Strong computer skills (Excel, Word required; Access, PowerPoint, Visio preferred) Experience with data entry, dual screens, and multiple systems Ability to work independently in a productivity-driven remote environment Strong attention to detail and documentation accuracy Preferred Experience Managed Care / PBM experience Prior Authorization, Coverage Determinations, or Appeals Medicare Part D knowledge and CMS guideline familiarity Remote pharmacist or high-volume review experience Retail + Managed Care hybrid background Schedule & Training Requirements Training: Monday–Friday, 9:00 AM – 5:30 PM EST (first 8 weeks – no time off allowed) Post-Training Schedule: Business Hours: 7:00 AM – 8:00 PM EST (Mon–Fri) Weekends: 7:00 AM – 4:30 PM EST Must be flexible to work assigned 8-hour shifts, including weekends Work Environment Requirements (MANDATORY) Dedicated, quiet, private workspace Wired internet connection: Minimum 25 Mbps download / 5 Mbps upload Speed test screenshot required (must be included on resume) Ability to remain on camera during training and team meetings Ability to sit and focus for full shift with minimal interruptions Submission Requirements (MUST BE INCLUDED ON RESUME) Screenshot of internet speed test ( www.speedtest.net ) Screenshot of active pharmacist license (showing name, state, expiration) Completed candidate questionnaire (see below) Candidate Pre-Screen Questionnaire (Include with Submission) Are you available for full-time training (M–F, 9–5:30 EST) for 8 weeks with no time off? Can you work any assigned 8-hour shift between 7 AM – 8 PM EST, including weekends? Do you have a dedicated, quiet workspace for remote work? Do you have wired internet meeting 25/5 Mbps requirements? Can you sit and focus for the entire shift without interruptions? Do you have experience with data entry and multiple systems/screens? Do you have an active pharmacist license in your state of residence? Are you comfortable working independently in a productivity-based role? Do you bring a positive, engaged attitude to a team environment? We are hiring 50 Remote Clinical Pharmacist Advisors to support Medicare Part D members and providers in a fast-paced, high-volume, production-driven environment. This role is ideal for pharmacists with prior authorization, managed care, or PBM experience who thrive in a structured, remote setting. As a Clinical Pharmacist Advisor, you will review pharmacy benefit requests, make clinical determinations, and ensure compliance with CMS and Medicare guidelines while delivering best-in-class service. Key Responsibilities Review and process prior authorizations, coverage determinations, and appeals Evaluate clinical documentation to support approval/denial decisions Ensure all cases meet Medicare Part D and CMS compliance standards Conduct provider outreach to obtain additional clinical information Document all decisions clearly and accurately in system workflows Manage high-volume queues while meeting productivity and quality metrics Apply clinical knowledge using drug compendia and established guidelines