Prior Authorization Pharmacist - Remote

Overview

Soleo Health is seeking a Prior Authorization Pharmacist to support our Specialty Infusion Pharmacy and work Remotely (USA). Join us in Simplifying Complex Care!

In Short

• Perform comprehensive clinical reviews for specialty pharmacy and infusion therapy prior authorization requests.
• Evaluate clinical documentation against payer-specific medical necessity criteria.
• Prepare, submit, and track prior authorization requests.
• Communicate with PBMs and health plans to clarify clinical information.
• Mitigate denials by addressing rejections in real time.
• Collaborate with patient access team to optimize patient access.
• Monitor authorization outcomes and track performance metrics.
• Stay current with evolving payer policies and regulatory requirements.
• Identify opportunities for workflow optimization.
• Support a great company culture with no weekends or holidays.

Requirements

• Doctor of Pharmacy (PharmD) or Bachelor of Pharmacy.
• Active, unrestricted U.S. pharmacist license.
• 2+ years of experience in prior authorization or managed care.
• Strong understanding of drug therapy and clinical guidelines.
• Excellent analytical and documentation skills.
• Proficiency in pharmacy benefit systems.
• Strong communication skills.
• Ability to manage multiple priorities.
• High level of integrity in handling confidential information.

Benefits

• Competitive wages.
• 401(k) with a match.
• Paid time off.
• Great company culture.
• Annual merit-based increases.
• Paid parental leave options.
• Affordable medical, dental, and vision insurance plans.
• Company paid disability and basic life insurance.
• Education assistance program.