Remote Clinical Review Pharmacist
Fully Remote | Long-Term Opportunity | Offers Benefits
Description
Candidates will be reviewing Commercial members' Utilization Management (UM) requests (i.e., formulary exceptions, prior authorization, step therapy, quantity limit exceptions). Client-specific criteria are referenced to determine if a prior authorization can be approved or denied. The work is detail-oriented, and candidates will be expected to provide clinical judgement and communication.
Responsibilities
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Responsible for the clinical evaluation for coverage determination requests for PA or other UM programs, including quantity limits, step therapy, formulary exception and tier exception, and includes consideration of the denial language and appropriateness of the decision as it pertains to the clinical content of the case and the intent of the individual client's pre-approved criteria
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Accountable for direct consultation with health care providers or members concerning non-formulary and clinical product coverage issues
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Collaborate with team members to promote consistency of decisions across the pharmacist team
Skills
Pharmacist, Retail, Clinical, Pharmacy Benefits Management, Pharmacy, Prior authorization, Pharmd, Compounding
Additional Skills & Qualifications
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Doctor of Pharmacy (PharmD) or equivalent
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2+yrs experience working in a retail environment
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Current pharmacist license in good standing with the State Board of Pharmacy in the State where the candidate is licensed. *Verify by searching (State) State Board of Pharmacy, ex: Oklahoma State Board of Pharmacy (will need license number from pharmacist). Also provide transparency on any disciplinary action taken on license which is provided in the search.
Job Type & Location
This is a Contract position based out of Dallas, TX.
Pay and Benefits
The pay range for this position is $55.00 - $55.00/hr.
Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: - Medical, dental & vision - Critical Illness, Accident, and Hospital - 401(k) Retirement Plan - Pre-tax and Roth post-tax contributions available - Life Insurance (Voluntary Life & AD&D for the employee and dependents) - Short and long-term disability - Health Spending Account (HSA) - Transportation benefits - Employee Assistance Program - Time Off/Leave (PTO, Vacation or Sick Leave)
Workplace Type
This is a fully remote position.
Application Deadline
This position is anticipated to close on May 7, 2026.
Diversity, Equity & Inclusion
At Actalent, diversity and inclusion are a bridge towards the equity and success of our people. DE&I is embedded into our culture through:
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Hiring diverse talent
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Maintaining an inclusive environment through persistent self-reflection
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Building a culture of care, engagement, and recognition with clear outcomes
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Ensuring growth opportunities for our people
Actalent is an equal opportunity employer.
About Actalent
Actalent is a global leader in engineering and sciences services. For more than 40 years, we've helped visionary companies advance their goals. Headquartered in the United States, our teams span 150 offices across North America, EMEA, and APAC-with four delivery centers in India led by 1,000+ extraordinary employees who connect their passion with purpose every day.
Our Bangalore, Hyderabad, Pune, and Chennai delivery centers are hubs of engineering expertise, with core capabilities in mechanical and electrical engineering, systems and software, and manufacturing engineering. Our teams deliver work across multiple industries including transportation, consumer and industrial products, and life sciences. We serve more than 4,500 clients, including many Fortune 500 brands. Learn more about how we can work together at ~~~.
