Remote PBM Prior Authorization Pharmacist

Company: A-Line Staffing Solutions LLC
Location: Atlanta
Posted on: June 24, 2025

Job Description:

Job Title: Remote PBM Prior Authorization Pharmacist Pay: $53 an hr | Bi-weekly Job Type: Remote Start date: 07/14/25 Shift Options: 7am to 10pm CST - 8 hours/day Training: M-F 8-4:30PM CST for 4 weeks *Possible weekend shifts* Remote PBM Prior Authorization Pharmacist Overview: The clinical pharmacist is an operation based role that conducts clinical reviews of medical data collected to perform prior authorization for specialty medications. The clinical pharmacist will apply clinical knowledge to plan approved criteria for prospective and concurrent reviews of cases. This role will work from supported systems and take inbound calls from physician or members regarding their pending, approved, or denied prior authorizations. Collaborates with the Technicians and Nurses to process authorization requests, including answering clinical questions, collecting appropriate clinical/ medical data needed to perform clinical assessments, and reviews as per the health plan/employer agreed criteria within the designated service level agreements. (20%) Coordinates timely communication of case decision to physician, health-plan/employer, patient and other healthcare professionals following agreed upon approval & denial management processes. (15%) Handles inbound phone calls and escalations from physicians or patients regarding Prior Authorization (50%) Establishes and maintains communication among health plan and employer group staff. (5%) Maintain professional and technical knowledge of drug and disease-states for the Specialty Medical programs administered within the Novologix. (5%) Performs other related projects and duties as assigned including on call and after hours pharmacist availability could be required. (5%)

Keywords: A-Line Staffing Solutions LLC, Johns Creek , Remote PBM Prior Authorization Pharmacist, Healthcare , Atlanta, Georgia