About this role
DescriptionThe Clinical Pharmacist supports the review of prior authorization and appeal requests by evaluating clinical documentation and making coverage determinations based on established criteria. This role involves collaborating with prescribers, pharmacies, and internal teams to obtain necessary clinical information, document decisions, and communicate outcomes. The pharmacist ensures reviews are completed accurately, efficiently, and in compliance with applicable regulatory and client requirements while contributing to process improvements within the prior authorization program.Additional Skills & QualificationsExperience working with multiple PBM platforms and payer-specific prior authorization workflowsFamiliarity with medical benefit vs. pharmacy benefit coverage determinationsExposure to appeals processing (first-level, second-level, or external review submissions)Working knowledge of managed care, utilization management, or health plan operationsExperience communicating clinical rationale to providers, pharmacies, or members in written or verbal formComfort reviewing specialty medications (e.g., biologics, oncology, immunology, rare disease)Understanding of CMS, state-level, and payer regulatory requirements related to prior authorizationExperience using workflow, ticketing, or case management systems for clinical reviewsAbility to identify process inefficiencies and contribute to workflow or policy improvementsExperience supporting high-volume or metrics-driven environments while maintaining quality standardsJob Type & LocationThis is a Contract position based out of Birmingham, AL. Pay and BenefitsThe pay range for this position is $50.00 - $55.00/hr. Individual compensation offered for this position within this range will depend on many factors, including qualifications, skills, relevant experience, job knowledge, geographic location, internal equity, and other pertinent job-related factors.Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following:
Medical, dental & vision Critical Illness, Accident, and Hospital 401(k) Retirement Plan Pre-tax and Roth post-tax contributions available Life Insurance (Voluntary Life & AD&D for the employee and dependents) Short and long-term disability Health Spending Account (HSA) Transportation benefits Employee Assistance Program Time Off/Leave (PTO, Vacation or Sick Leave) Workplace TypeThis is a fully remote position. Application DeadlineThis position is anticipated to close on Oct 9, 2026.About Actalent
Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 20,000 consultants and 5,000 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500. We are proud to be an Engineering News-Record (ENR) Top 500 Design Firm for our engineering design services and a ClearlyRated Best of Staffing® winner for both client and talent service.
The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please email [email protected] for other accommodation options.
San Francisco Fair Chance Ordinance: Pursuant to the San Francisco Fair Chance Ordinance, for all positions located in the city and county of San Francisco, we will consider for employment qualified applicants with arrest and conviction records.
Massachusetts Lie Detector: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.
Use of Artificial Intelligence (AI): We may use Artificial Intelligence (AI) to support parts of our hiring process, including sourcing, screening, and evaluating candidates. AI helps assess applications and qualifications, but final decisions are made by our hiring team. By applying, you acknowledge and agree that your application may be reviewed using AI tools.