Remote Clinical Pharmacist – Prior Authorization

A-Line Staffing is now hiring a Remote Clinical Pharmacist – Prior Authorization in Arizona or Texas. Please contact Staffing Manager, Tiona Scroggins @ tscroggins@alinestaffing.com. Job Title: Remote Clinical Pharmacist – Prior Authorization Job Code: 177998 Location: Fully Remote – Arizona or Texas Pay Rate: $65.75 per hour Assignment Start Date: November 16, 2026 Assignment End Date: May 15, 2027 Employment Type: Temporary to Permanent (Temp-to-Perm), with the opportunity for an extension or permanent placement based on business needs. Work Schedule: Monday – Friday, 10:00 AM – 6:30 PM Arizona Time (after training). Training Schedule: Monday – Friday, 8:00 AM – 4:30 PM Arizona Time (approximately 8 weeks). Work Environment: 100% Remote – No onsite requirements. Patient-Facing: No. Position Overview The Remote Clinical Pharmacist – Prior Authorization is responsible for reviewing, evaluating, and adjudicating medication prior authorization requests to ensure appropriate, safe, and cost-effective medication therapy. This position supports Medicaid Prior Authorization and requires a licensed pharmacist who can apply clinical judgment, evidence-based guidelines, formulary requirements, and regulatory standards when making medication authorization decisions. The pharmacist will evaluate medication requests based on medical necessity, clinical appropriateness, patient-specific information, and formulary compliance. Responsibilities include authorizing, modifying, or denying medication requests, documenting clinical rationale, collaborating with other healthcare professionals, and maintaining established productivity, quality, and turnaround time standards. This is a fully remote position and is not patient-facing. Job Responsibilities Prior Authorization Review and Clinical Decision-Making: Review, assess, and adjudicate medication prior authorization requests for medical necessity, clinical appropriateness, and formulary compliance. Apply evidence-based clinical guidelines, drug compendia, FDA labeling, and plan-specific criteria when making authorization decisions. Evaluate patient-specific clinical factors, including: Patient diagnosis. Laboratory results. Previous medication therapies and treatment history. Medication dosing and dosage requirements. Contraindications. Comorbid conditions. Determine whether medication requests meet established clinical and plan-specific requirements. Authorize, modify, or deny medication requests based on clinical findings and established criteria. Document clinical rationale for all authorization decisions clearly and accurately. Clinical Collaboration and Case Escalation: Collaborate with pharmacy technicians, nurses, medical directors, and other clinical staff to resolve complex prior authorization cases. Support peer-to-peer reviews when necessary. Prepare clinical summaries when cases require escalation or additional review. Communicate clinical findings and recommendations to appropriate team members. Regulatory Compliance and Quality Assurance: Ensure compliance with applicable state and federal regulations. Follow accreditation standards, including NCQA and URAC requirements. Maintain compliance with internal policies, procedures, and audit requirements. Ensure accurate and complete documentation within prior authorization and pharmacy management systems. Maintain established quality standards and support audit readiness. Productivity and Workflow Management: Meet established productivity expectations and turnaround time requirements. Maintain quality benchmarks for prior authorization processing. Work efficiently in a high-production team environment. Manage multiple authorization requests while maintaining accuracy and clinical integrity. Ensure all prior authorization activities are documented appropriately. Required Qualifications and Experience Candidates must meet the following requirements: Active Pharmacist License: Must possess an active, unrestricted pharmacist license in either Arizona (AZ) or Texas (TX). License Standing: License must be in good standing with no restrictions. License Verification: A screenshot of the active, unrestricted AZ or TX pharmacist license must be included at the top of the resume. Pharmacy Experience: Minimum of 3 years of experience working as a pharmacist. Clinical Decision-Making: Experience applying evidence-based clinical guidelines and clinical criteria when making medication-related decisions. Formulary Knowledge: Experience utilizing formularies and preferred drug lists. High-Production Environment: Experience working in a high-production team environment while maintaining productivity and accuracy. Clinical Program Knowledge: Knowledge of clinical program components, formulary designs, and prescription benefit trends. Education: Bachelor's degree in Pharmacy or Doctor of Pharmacy (PharmD) required. High School Education: Verifiable High School Diploma or GED required. Important License Requirement: Candidates must have an active and unrestricted Arizona or Texas pharmacist license in good standing. A screenshot of the license must be placed at the top of the submitted resume. Education Requirements High School Diploma or GED – Required and must be verifiable. Bachelor's Degree in Pharmacy or Doctor of Pharmacy (PharmD) – Required. At least 2 years of pharmacist experience is specified in the education requirements; the position's experience requirements separately specify a minimum of 3 years of pharmacist experience. Active, unrestricted AZ or TX pharmacist license in good standing – Required. Required Knowledge and Skills Candidates should have knowledge and experience in the following areas: Clinical Guidelines: Understanding and application of evidence-based clinical guidelines and criteria. Medication Management: Ability to evaluate medication requests for medical necessity, safety, and clinical appropriateness. Formulary Compliance: Knowledge of formularies, preferred drug lists, and plan-specific medication requirements. Clinical Assessment: Ability to evaluate diagnoses, laboratory results, prior therapies, dosing, contraindications, and comorbidities. Drug Information: Ability to reference drug compendia, FDA labeling, and other evidence-based clinical resources. Prior Authorization: Understanding of medication prior authorization review, adjudication, and utilization management processes. Regulatory Compliance: Knowledge of applicable state and federal regulations and accreditation requirements. Accreditation Standards: Familiarity with NCQA and URAC standards. Documentation: Ability to accurately document clinical decisions and supporting rationale. Clinical Communication: Ability to collaborate with pharmacy technicians, nurses, medical directors, and other healthcare professionals. Problem-Solving: Ability to assess complex medication requests and determine when escalation is necessary. Time Management: Ability to meet productivity requirements, quality expectations, and turnaround time benchmarks. Technology: Ability to work within prior authorization and pharmacy management systems. Work Schedule and Training Details Training Period: Monday – Friday. 8:00 AM – 4:30 PM Arizona Time. Approximately 8 weeks of training. Regular Work Schedule (After Training): Monday – Friday. 10:00 AM – 6:30 PM Arizona Time. Candidates must be comfortable working both the required training schedule and the regular post-training schedule. All hours are based on Arizona time. Remote Work Requirements This is a 100% remote position. Candidates will never be required to report onsite. This is not a patient-facing position. Candidates must be able to complete clinical reviews, documentation, and collaboration responsibilities remotely. Candidates must be comfortable working independently while remaining productive in a team-based environment. What Candidates Should Know Before Applying Pay Rate: $65.75 per hour. Assignment Dates: November 16, 2026 – May 15, 2027. Employment Type: Temporary to Permanent (Temp-to-Perm), with the opportunity for an extension or permanent placement based on business needs. Location: Fully remote. Eligible Licenses: Active, unrestricted Arizona or Texas pharmacist license in good standing. License Documentation: A screenshot of the active pharmacist license must be placed at the top of the resume. Experience: Minimum of 3 years working as a pharmacist. Education: Bachelor's degree in Pharmacy or PharmD required, along with a verifiable High School Diploma or GED. Training: Approximately 8 weeks, Monday through Friday, 8:00 AM – 4:30 PM Arizona Time. Regular Hours: Monday through Friday, 10:00 AM – 6:30 PM Arizona Time after training. Prior Company Experience: Previous experience with CVS or Aetna is not required. Work Environment: No onsite reporting or patient-facing responsibilities. Primary Focus: Clinical medication prior authorization reviews, medical necessity determinations, formulary compliance, and utilization management. Ideal Candidate The ideal candidate is an experienced, licensed pharmacist with strong clinical judgment and a solid understanding of medication prior authorization processes. They should be comfortable reviewing complex medication requests, applying evidence-based clinical guidelines, evaluating patient-specific information, and making accurate authorization decisions. Candidates should also have experience working in a fast-paced, high-production environment while maintaining strong documentation, quality, and productivity standards. To Apply: Interested candidates should submit an updated resume highlighting their clinical pharmacy and prior authorization experience. Important: Please ensure a screenshot of your active, unrestricted Arizona or Texas pharmacist license is included at the top of your resume. For questions or additional information, please contact: Tiona Scroggins Staffing Manager Email: tscroggins@alinestaffing.com #INDKS