Fully Remote Pharmacist

Insight Global
  • Remote
  • $59 Per Hour
  • Full-time
  • Instant Apply
15 days ago

Job Description

OptumRx is seeking licensed Pharmacists to support a high-volume, fully remote pharmacy operation. This position is responsible for reviewing medication prior authorization and appeal requests and determining coverage based on clinical guidelines, pharmacy policies, and health plan benefits.

Pharmacists will review patient clinical information, make coverage determinations, recommend formulary alternatives, and collaborate with providers, pharmacy technicians, and internal teams. This is a fast-paced, production-driven environment requiring strong clinical judgment, attention to detail, organization, and the ability to work independently.

Job Responsibilities

Day-to-Day Responsibilities

  • Review prior authorization requests
  • Review medication appeal cases
  • Analyze patient clinical information and documentation
  • Make coverage determinations based on established guidelines
  • Recommend appropriate formulary alternatives
  • Communicate with physicians and healthcare providers
  • Collaborate with pharmacy technicians and internal teams
  • Accurately document case decisions
  • Ensure compliance with Medicare Part D, Medicaid, commercial benefit, and regulatory requirements
  • Manage a high daily case volume
  • Meet established productivity and quality metrics
  • Respond to provider and pharmacy inquiries
  • Support quality assurance efforts

Participate in process improvement initiatives

Numbers & Facts

Location (
Remote
)
Job TypeFull-time
IndustryHealthcare Services
Salary$59 Per Hour
Year Founded2001
HeadquartersAtlanta, Georgia, US
Websitehttp://www.insightglobal.net

Qualifications

  • Active State Pharmacy License
  • Bachelor of Pharmacy or PharmD
  • Currently Licenses in State of Employment

Benefits

401K, Medical, Dental, Vision

About Company

Company Context

ASP is a medical supply company selling products such as syringes, gowns, wound care products, and other healthcare supplies to hospitals and large physician groups.
The company is in growth mode and is targeting roughly 3x revenue growth.
They have been overhauling supply chain operations and have already transformed 4 of their 5 supply chain organizations.
The previous person in the role was promoted to Director, which suggests there is visibility and growth potential.

Skills

  • Clinical Practices/Protocolsunmatched
  • Detail Orientedunmatched
  • Health Planunmatched
  • Medicationsunmatched
  • Organizational Skillsunmatched
  • Pharmacyunmatched
  • Production Systemsunmatched

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