About this opportunity
A-Line Staffing Solutions lists this Remote Prior Authorization Pharmacist opportunity in woonsocket, Rhode Island. Review the employer’s description below for duties, qualifications and application requirements.
Job description
Job Title
Remote Prior Authorization Pharmacist (Pharmacist – Prior Auth)
Location
Remote (continental U.S.; not available in New Mexico or Colorado)
Schedule
Full-time | Sun–Thurs or Tues–Sat (CST shifts)
Shift Options (CST)
10:30am–7:00pm | 11:00am–7:30pm | 11:30am–8:00pm
Training
Nov 9–Dec 4 | Mon–Fri 8:00am–4:30pm CST (mandatory)
Pay
$53.00/hour
Summary
Hiring a Remote Pharmacist to complete criteria-based prior authorization (PA) reviews and issue coverage determinations for specialty and non-specialty pharmacy programs. This is a great fit for pharmacists with PBM / managed care / health plan experience who are comfortable working high-volume cases, communicating determinations, and documenting accurately in multiple systems. If you’re searching for remote pharmacist jobs, prior authorization pharmacist, PBM pharmacist, or managed care pharmacist roles—this opportunity offers structured training and consistent schedules.
Responsibilities
Review prior authorization requests and render coverage determinations using clinical criteria and plan design
Verify insurance eligibility/coverage; interpret clinical guideline criteria
Consult with providers as needed; communicate approvals/denials promptly and professionally
Collaborate with technicians and PA team members to gather required clinical documentation
Handle inbound/outbound calls with providers/members/PA team to resolve escalations and answer questions
Maintain current knowledge of drug and disease states for specialty and non-specialty therapies
Document all activity clearly and accurately while meeting service level expectations
Qualifications
Active Pharmacist license (unrestricted; in good standing)
Prior authorization review experience (PBM / managed care / health plan strongly preferred)
Strong clinical judgment, documentation skills, and attention to detail
Professional phone presence; comfortable with provider outreach and high-volume workflows
Able to work in a secure home office and maintain confidentiality (HIPAA/privacy standards)
Reliable high-speed internet (min 25 Mbps download / 3 Mbps upload) and a smartphone (VPN token required)
Dedicated private workspace; hard requirement to complete training and assigned schedule
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Who can apply
Review the original listing for work authorization, qualifications and employer requirements.