Remote Pharmacist (Prior Auth)

About the position

The Remote Pharmacist (Prior Authorization) position at Judge Healthcare involves processing member prescriptions and prior authorizations while ensuring compliance with pharmacy laws and regulations. This full-time role requires a pharmacist licensed in Illinois and includes a 4-week training period with no time off. The position emphasizes strong customer service and collaboration with healthcare providers.

Responsibilities

• Decisioning and processing member prescriptions or prior authorizations through various computer systems.
• Receiving phone calls from prior authorization pharmacy technicians and/or providers for clinical information.
• Consulting with physicians/providers regarding questions and interpreting clinical guideline criteria.
• Rendering and reviewing coverage determinations for prior authorization cases.
• Advising pharmacy technicians and/or physicians on appropriate formulary alternatives when requested.
• Gathering complex clinical information and working within regulatory guidelines to make coverage determinations.
• Organizing workload, setting priorities, and completing assignments in a timely manner.
• Complying with state and federal pharmacy laws and regulations.
• Supporting department quality assurance and improvement guidelines.
• Building rapport with coworkers and demonstrating a strong customer service orientation.

Requirements

• Pharmacist License in the state of residence (Illinois).
• Candidate must have their own home internet access/VPN.
• Candidate must have a secure workspace/office in their home.
• Candidate must have level skill with working with PC (e.g., using mouse and keyboard, navigating multiple systems).
• Excellent attendance is a must.

Benefits

• Contract to hire opportunity based on performance.
• Full-time position with scheduled overtime and holiday work.