Remote Pharmacist (RPh Advisor) – Medicare Part D Appeals & Case Review
Location: Remote (must hold active pharmacist license in state of residence)
Schedule: Training: Monday–Friday 9:00am–5:30pm EST (first 8 weeks). After training: rotating 8-hour shifts between 7:00am–8:00pm EST (Mon–Fri) and 7:00am–4:30pm EST (Sat/Sun), including weekend coverage.
Pay: $53/hr
JOB STARTS JULY 19, 2026!!
Summary
Seeking a licensed Registered Pharmacist for a remote case-review role supporting Medicare Part D members and providers. You’ll ensure accurate case setup, review clinical documentation for decisioning, contact providers to obtain missing information, and document decisions that comply with Medicare guidance and CMS timelines.
Responsibilities
- Set up Medicare Part D requests/appeals cases accurately and completely
- Review clinical information and supporting documentation for decisioning
- Contact providers for additional clinical details as needed
- Document case reviews clearly, accurately, and consistently
- Use drug compendia resources, work instructions, and updated CMS guidance
- Meet turnaround times, productivity expectations, and quality standards
- Engage in coaching/development feedback sessions
Qualifications
- Active RPh license in good standing in your state of residence (required)
- Strong documentation and clinical judgment; detail-focused and timeline-driven
- Comfortable with heavy data entry and navigating multiple applications using two screens
- Excel and Word required; Access/PowerPoint/Visio preferred
- Dedicated, quiet workspace and ability to be on camera for meetings/training
- Wired internet 25 Mbps download / 5 Mbps upload minimum
- No conflicts with required training schedule (8 weeks, M–F 9:00am–5:30pm EST)