Prior Authorization Pharmacist

Gainwell Technologies

Prior Authorization Pharmacist reviewing medication requests for compliance with clinical guidelines. Collaborating with providers and internal teams to enhance utilization management processes.

Posted 5/16/2026full-timeRemote • Wisconsin • 🇺🇸 United StatesMid-LevelSenior💰 $90,900 - $129,900 per yearWebsite

About the role

Key responsibilities & impact

Review Prior Authorization requests from medical professionals to ensure alignment with Preferred Drug List (PDL) criteria and current clinical guidelines
Support Peer to Peer discussions with medical providers to discuss Prior Authorization reviews
Collaborates on the refinement of consultation scripting; solicits and utilizes input from those contacted toward scripting improvements
Contributes to the success of the Clinical Call Centers and Prior Authorization department by assisting with the implementation and management of both written and verbal communications to members and physicians
Is available for consultation on pharmacy-related questions and issues for others within the organization
Contributes to program improvements by using continuous quality improvement processes

Requirements

What you’ll need

PharmD or B.S. in Pharmacy with relevant Specialty background
Registered Pharmacist with unrestricted respective State Licensure (Wisconsin Pharmacist License Preferred but not required)
4 years’ experience in clinical pharmacy
Strong verbal and written communications skills
Highly skilled with Microsoft Office products and ability to quickly learn proprietary systems

Benefits

Comp & perks

generous, flexible vacation policy
401(k) employer match
comprehensive health benefits
educational assistance
variety of leadership and technical development academies

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

clinical pharmacyPrior AuthorizationPreferred Drug Listconsultation scriptingquality improvement processes

Soft Skills

verbal communicationwritten communicationcollaboration

Certifications

PharmDB.S. in PharmacyRegistered PharmacistWisconsin Pharmacist License