Pharmacist

Candidates will review members’ Utilization Management (UM) requests, including formulary exceptions, prior authorization, step therapy, and quantity limit exceptions. Client-specific criteria are referenced to determine if a prior authorization can be approved or denied. The work is detail-oriented, requiring clinical judgment and communication.

Responsibilities

• Conduct clinical evaluations for coverage determination requests for prior authorization (PA) or other UM programs, including quantity limits, step therapy, formulary exceptions, and tier exceptions.
• Assess the appropriateness of decisions based on the clinical content of the case and the intent of the individual client’s pre-approved criteria.
• Provide direct consultation with healthcare providers or members concerning non-formulary and clinical product coverage issues.
• Collaborate with team members to promote consistency of decisions across the pharmacist team.
• Perform other duties as assigned.

Interaction Level

• Role is primarily independent with routine structured touchpoints.
• Regular communication with supervisors, pharmacists, technicians, and other team members via Teams messaging platforms, phone, and video calls.
• Cameras/video calls used for training sessions, team meetings, and routine 1:1s with supervisors.
• Pharmacists are available throughout the day to support clinical questions and provide guidance.

Success Metrics

• Productivity: Complete cases efficiently, consistent with the team average.
• Accuracy: Achieve and maintain a quality score (error-free rate) of 95%.
• Accountability: Demonstrate a strong attendance record and excellent communication skills.
• Team/Culture Fit: Receptive to feedback, focus, problem-solving, accuracy, learning agility, sound clinical judgment, and ability to work independently while collaborating with a team-player attitude.

Skills

• Quickly learn new systems and comfortable with multi-monitor setups.
• Adept at navigating multiple platforms, using available resources, Microsoft applications, and AutoHotkey.

All new pharmacists are considered potential long-term employees, with the hope of hiring as permanent employees in the future. Contracts are evaluated every 6 months for extension, though a timeline for conversion cannot be guaranteed.

Job Type & Location

This is a contract position based out of Charlotte, NC.

Pay

The pay range for this position is $55.00/hour.

Benefits

Eligibility requirements apply to some benefits and may depend on job classification and length of employment. Benefits are subject to change and may include:

• Medical, dental, and vision insurance.
• Critical Illness, Accident, and Hospital coverage.
• 401(k) Retirement Plan (pre-tax and Roth post-tax contributions available).
• Life Insurance (voluntary life and AD&D for employees and dependents).
• Short- and long-term disability.
• Health Spending Account (HSA).
• Transportation benefits.
• Employee Assistance Program.
• Time Off/Leave (PTO, vacation, or sick leave).

Schedule

This is a fully remote position.

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.