Actalent
Eagan, MN
Job Title: Remote Clinical Pharmacist - Medicare UMJob Summary We are seeking a Remote Clinical Pharmacist to review Medicare utilization management requests, including prior authorizations, formulary exceptions, step therapy, and quantity limits. This role focuses on applying clinical criteria to approve or deny medication coverage and is ideal for pharmacists looking to move away from retail pharmacy into a clinical, work-from-home role. Key Responsibilities Review Medicare prior authorization and formulary exception requests Apply client-specific clinical criteria to make approval or denial decisions Use independent clinical judgment while following established guidelines Communicate with providers or members regarding coverage decisions Document decisions accurately and maintain high quality standards Meet productivity and accuracy metrics (95%+ quality target) Collaborate virtually with pharmacists and supervisors Must-Have...

