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Job description
This opportunity offers a dynamic role for a licensed pharmacist specializing in utilization management within a fast-paced, evolving environment. The position involves a contract-to-hire engagement, focusing on Part B drug and biologic prior authorization and appeals review, with a commitment to driving clinical accuracy and process improvement.
Location: Remote
Schedule: Monday-Friday, 12:00 PM-8:30 PM EST
Weekend & Holiday Rotation: Mandatory
Duration: October 1, 2026 - March 31, 2027 (6-month contract)
Contract Type: Temp to Hire
Responsibilities:
Review Part B drug and biologic prior authorization requests and appeals with clinical accuracy.
Apply clinical policies, utilization management criteria, and Medicare guidelines to authorization decisions.
Provide support to internal clinical and non-clinical teams regarding Part B drug policies and workflow inquiries.
Identify and implement opportunities to improve review quality, accuracy, and operational efficiency.
Adapt to changing priorities while maintaining consistency in quality and productivity.
Commit to mandatory weekend and holiday rotations with emergency-day-off exceptions only between January 1 and March 31, 2027.
Qualifications: PharmD degree with an active pharmacist license in at least one state.
Minimum of 2 years' experience in utilization management, managed care residency, or relevant specialty pharmacy settings.
Demonstrated strong clinical judgment capable of independently managing complex Part B drug requests.
Experience with Part B drug prior authorization and appeals review processes.
This role is ideal for pharmacy professionals seeking to leverage their clinical expertise in utilization management while contributing to improved healthcare outcomes. If you meet the qualifications and are ready to engage in a challenging, rewarding role, apply now to advance your career in pharmacy.
Compensation for this position ranges from $52.00 to $72.00. 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.
Worksite address
quincy, MA, 02171, US
Who can apply
Review the original listing for work authorization, qualifications and employer requirements.