Clinical Pharmacy Reviewer (Pharmacist) - Remote
Dane Street · United States · US
Utilization Review
Remote
physician
Pharmacist
Demand82
Career growth68
Healthcare fit88
Remote potential98
5-year outlook
Stable demand for pharmacist reviewers in PBM and utilization management, with compensation typically competitive with clinical pharmacist roles but potential plateau without moving into managed care leadership or broader health plan strategy.
Clinical license
Required
Applicant reach
moderate
Seniority
mid
Employment type
–
Date found
2026-10-03
Intelligence details
Flexible work details
- Side income
- Classified as side-income friendly
- Engagement type
- Contract
- Hours
- Variable hours
- Eligible countries
- United States
- License jurisdiction
- US
- Profession fit
- physician, Pharmacist
- Rate period
- Annual
Why this was classified this way
- Contractor
Listing via Himalayas.
Eligibility, licensing, and location restrictions can change. Always confirm details on the source posting before applying.
Why this is worth applying to
Strong fit for pharmacists with PBM prior authorization or appeals experience seeking remote non-clinical work; less accessible for pharmacists without managed care or utilization review background.
Who should apply
Pharmacists with a PharmD, active license, and 3+ years in PBM prior authorization, appeals, or utilization review; Medicare Part D, Medicaid, and formulary management experience is preferred.
CV angle
Highlight PBM prior authorization and appeals review, DUR, formulary management, step therapy, quantity limits, specialty medication criteria, Medicare Part D/Medicaid, and clinical guideline interpretation. Quantify case volumes, turnaround times, and compliance or quality outcomes.
Skills to highlight
- Drug Utilization Review (DUR)
- Prior Authorization Review
- Appeals Review
- Pharmacy Benefit Management (PBM)
- Formulary Management
- Step Therapy & Quantity Limits
- Medicare Part D/Medicaid
- Clinical Guideline Interpretation
Role summary
Remote pharmacist reviewer role performing clinical pharmacy prior authorization and appeals reviews, applying PBM formulary criteria, step therapy, quantity limits, and DUR to determine medical necessity for specialty and non-specialty medications.
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