Pharmacist in Saint Paul, MN

This opportunity is for a dedicated pharmacist with a strong background in utilization management and Part B drug knowledge to support a remote healthcare team. The role offers a contract-to-hire position with a focus on ensuring members and providers understand benefits and appeals processes related to prior authorizations and Medicare regulations.

Key Responsibilities:

• Review prior authorization requests for drugs and equipment covered under Part B benefits
• Analyze and assess appeals of previously denied requests
• Collaborate with providers and members to clarify benefit utilization and improve health outcomes
• Support internal clinical and non-clinical staff with policy and procedure guidance

Desired Qualifications:

• Minimum of 2 years’ experience in utilization management or completion of a managed care residency
• In-depth knowledge of Medicare regulations, Part B drug coverage, and prior authorization processes
• Understanding of payer-provider-manufacturer dynamics affecting patient care
• Experience with pharmacy-related quality assurance or transitional care medication reconciliation preferred
• Ability to work as part of a multidisciplinary care team during care transitions
• Cultural competency across diverse populations is highly valued
• Active pharmacist license in at least one state
• Must be available to work on Central Standard Time (CST) schedule

Schedule:

• Monday through Friday, 10:00 AM to 7:00 PM EST (equivalent to 9:00 AM to 6:00 PM CST)
• Rotating weekend on-call duties
• Training begins December 1

Additional Information:

• Fully remote position with all necessary equipment provided
• Contract to hire opportunity, allowing for career growth and long-term engagement

If you have the expertise in utilization management combined with a commitment to improving patient care within a managed care environment, apply now to be considered for this dynamic remote pharmacist role.

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.