Pharmacist | Minneapolis, Minnesota

This opportunity seeks a licensed pharmacist to support utilization management with a focus on Medicare Part B drug benefits. The role involves reviewing prior authorization requests, managing appeals, and assisting members and providers in understanding benefit coverage to optimize patient health outcomes.

Key Responsibilities:

• Review and process prior authorization requests for drugs and equipment under Medicare Part B.
• Evaluate appeals for previously denied requests.
• Educate members and providers on benefits and pharmacy policies.
• Support clinical and non-clinical teams with policy clarifications and procedural guidance.

Qualifications and Experience:

• Minimum of 2 years experience in utilization management or completion of a managed care residency.
• Strong knowledge of Part B drug requirements and prior authorization processes.
• Understanding of Medicare regulations and reimbursement methodologies.
• Familiarity with the dynamics between payers, providers, and drug manufacturers.
• Experience in pharmacy-related quality assurance or quality improvement initiatives preferred.
• Ability to work collaboratively as part of a multidisciplinary team, especially during care transitions.
• Cultural competency with diverse populations is a plus.
• Active pharmacist license in at least one state.
• Must be able to work on Central Standard Time (CST) schedule.

Location: Remote (Applicants should be located in or able to align with the CST work hours.)

Schedule:

• Monday to Friday, 10:00 AM – 7:00 PM EST / 11:00 AM – 8:00 PM CST
• Rotating weekend on-call shifts
• Training begins December 1

This contract to hire position offers an engaging environment to contribute to a remote team dedicated to improving patient outcomes through effective managed care pharmacy practices. Equipment and necessary tools are provided.

Candidates interested in applying should have the required experience and licensing, and be prepared for a CST schedule with potential weekend support duties. Take the next step in advancing your pharmacy career by applying today.

Compensation for this position ranges from $45.00 to $63.00. Eligible candidates may also receive healthcare benefits, housing, and meals/incidentals. Full details of our healthcare benefits plan can be found here. This posting is open for 60 days after the posting date.