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Remote Authorization information

What is a remote authorization?

A Remote Authorization job typically involves reviewing, verifying, and approving requests for access, transactions, or services from a remote location. Professionals in this role work in industries like healthcare, finance, or IT, ensuring compliance with policies and security standards. They assess authorization requests, analyze supporting documents, and use software tools to make informed decisions. Strong attention to detail, communication skills, and familiarity with relevant regulations are essential for success in this role.

What does a remote authorization do?

In a Remote Authorization role, your day usually involves reviewing medical or service requests, verifying patient eligibility, and ensuring all required documentation is complete before approving or denying authorization. You may interact with healthcare providers, patients, and insurance companies to gather information and clarify details as needed. The role often requires maintaining up-to-date records in internal systems and adhering to company or legal guidelines on privacy and compliance. Since the work is remote, staying organized and proactive in digital communication is essential to success. The position also provides opportunities to develop expertise in healthcare policies and can serve as a foundation for career advancement in medical administration or insurance.

What are the key skills and qualifications needed to thrive in remote authorization?

To excel as a Remote Authorization professional, you need strong analytical skills, attention to detail, and a background in healthcare administration or insurance processes. Familiarity with claims management software, electronic health records (EHR), and relevant compliance certifications such as HIPAA are often required. Effective communication, problem-solving, and time management are vital soft skills for collaborating with team members and handling authorization requests efficiently. These competencies are crucial to ensure accurate, timely approvals and to maintain compliance with organizational and regulatory standards.

What are the most commonly searched types of Authorization jobs in California?

The most popular types of Authorization jobs in California are:

What are popular job titles related to Remote Authorization jobs in California?

For Remote Authorization jobs in California, the most frequently searched job titles are:

What job categories do people searching Remote Authorization jobs in California look for?

The top searched job categories for Remote Authorization jobs in California are:

What cities in California are hiring for Remote Authorization jobs?

Cities in California with the most Remote Authorization job openings:

Remote Authorization jobs near you
Infographic showing various Remote Authorization job openings in California as of September 2026, with employment types broken down into 1% Internship, 1% As Needed, 83% Full Time, 12% Part Time, 1% Temporary, and 2% Contract. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution.

Medical Reviewer (Pharmacist) - Remote CA

West Sacramento, CA • Remote

Gainwell Technologies
Health Care and Social Assistance • 10K+ employees
Learn more about Gainwell Technologiesexternal

$100K - $140K/yr

Full-time

Medical, Life, Retirement, PTO

Posted 21 days ago

Key responsibilities

  • Perform pharmacy and medication-related clinical reviews.

  • Support pharmacy claim review and adjudication activities.

  • Document findings and recommendations accurately and timely.

Gainwell Technologies rating

7.9

Company rating: 7.9 out of 10

Based on 84 frontline employees who took The Breakroom Quiz

Job description

It takes great medical minds to create powerful solutions that solve some of healthcare's most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you've honed your career in a fast-moving medical environment. While Gainwell operates with a sense of urgency, you'll have the opportunity to work more flexible hours. And working at Gainwell carries its rewards. You'll have an incredible opportunity to grow your career in a company that values work-life balance, continuous learning, and career development.

Summary

Gainwell Technologies is seeking a Medical Reviewer (Pharmacist) to provide pharmacy and clinical expertise supporting Medical Review Services for California healthcare programs. This role supports pharmacy review, claim adjudication, drug rebate activities, drug utilization review, Treatment Authorization Requests (TARs), and other Medical Review Services functions.

Your role in our mission
  • Perform pharmacy and medication-related clinical reviews.
  • Support pharmacy claim review and adjudication activities.
  • Provide clinical expertise for drug utilization review and drug-related authorization requests.
  • Support drug rebate and pharmacy program activities as assigned.
  • Review pharmacy documentation for compliance with applicable policies and coverage requirements.
  • Provide technical expertise and assistance related to pharmacy review.
  • Document findings and recommendations accurately and timely.
  • Collaborate with physicians, nurses, pharmacy teams, operations, and other healthcare professionals.
  • Maintain knowledge of applicable pharmacy policies and regulatory requirements.
What we're looking for
  • Current, non-expired pharmacist license from the State of California, in good standing.
  • Must not be under suspension from Medicare, Medicaid, or pharmacy practice in California.
  • Must not have been previously sanctioned for fraud or abuse.
  • Three (3) years of previous experience as a pharmacy consultant for a government or private-sector healthcare payer; or one (1) year of MMIS experience in a large state providing technical expertise and assistance for pharmacy review.
  • Strong oral and written communication skills.
  • Strong knowledge of pharmacy practices, medication review, and healthcare reimbursement processes.
What you should expect in this role
  • Full-time position.
  • Remote work environment.
  • Monday through Friday work schedule.
  • Work primarily from your home office while supporting Medical Review Services for California healthcare programs.
  • Spend the majority of your day reviewing pharmacy, clinical, claim, authorization, and supporting documentation.
  • Work independently while collaborating with physicians, pharmacists, nurses, other clinical specialists, operations teams, and business partners.
  • Navigate multiple computer systems and applications to complete reviews, document findings, and support timely determinations.
  • Maintain all professional licenses, certifications, and credentials required for the position in active, unrestricted, and good-standing status.
  • Maintain knowledge of applicable medical and pharmacy policies, coverage requirements, clinical standards, and regulatory guidelines.
  • Meet established quality, accuracy, productivity, and turnaround-time expectations.
  • Receive ongoing training and support related to program requirements, systems, policies, and medical review processes.
  • Travel requirement: 0-10%.

This position is being posted for pipeline purposes, and we welcome applications on an ongoing basis.

#LI-REMOTE

#LI-MA1

The pay range for this position is $100,000 - $140,000 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. Put your passion to work at Gainwell. You'll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits, and educational assistance. We also have a variety of leadership and technical development academies to help build your skills and capabilities.

We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Build your career with Gainwell, an industry leader. You'll be joining a company where collaboration, innovation, and inclusion fuel our growth. Learn more about Gainwell at our company website and visit our Careers site for all available job role openings.

Gainwell Technologies is an Equal Opportunity Employer, where all qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical condition), age, sexual orientation, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. Gainwell Technologies defines "wages" and "wage rates" to include "all forms of pay, including, but not limited to, salary, overtime pay, bonuses, stock, stock options, profit sharing and bonus plans, life insurance, vacation and holiday pay, cleaning or gasoline allowances, hotel accommodations, reimbursement for travel expenses, and benefits.

What Gainwell Technologies employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

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About Gainwell Technologies

Sourced by ZipRecruiter

With Health and Cost outcomes that pierce Inequities and Impact Economies, the success of our Nation’s Federal Medicaid program is inextricably tied to the Prosperity of Communities, States and the Nation as a whole. We think that deserves Respect and a Commitment from Innovators who can help those who operate within and around health and human services evolve to meet their goals. At Gainwell, that’s our Sole focus. Built across more than Five Decades, Gainwell has intentionally seized opportunities to advance its digitally enabled services to meet Agencies, Health plans and MCOs where they are on their modernization journeys and propel them into the future of Healthcare. Equally important to our Expanding Technologies and Results. We bring ideas that bring policies to life.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Irving, TX, US

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