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Remote Prior Authorization Pharmacist Jobs in Springfield, IL

AltaStaff, LLC

Care Review Clinician

Springfield, IL · Remote

$40 - $42/hr

This is a fully remote role but candidates must have a valid RN license in Illinois*** Position ... Verify member benefits and eligibility and Process prior authorization determinations within ...

micro1 AI

Biostatistician

Springfield, IL · Remote

$60 - $100/hr

Remote micro1 is engaging Biostatisticians to contribute to a customer's advanced project in AI ... No prior experience in AI is required -- your domain knowledge is what matters. Scope of Work

micro1 AI

Director of Biostatistics

Springfield, IL · Remote

$60 - $100/hr

Remote micro1 is engaging Biostatisticians to contribute to a customer's advanced project in AI ... No prior experience in AI is required -- your domain knowledge is what matters. Scope of Work

All JobsPrior Authorization Pharmacist JobsRemote Prior Authorization Pharmacist JobsRemote Prior Authorization Pharmacist Jobs in Springfield, IL

Remote Prior Authorization Pharmacist information

See Springfield, IL salary details

$27

$60

$73

How much do remote prior authorization pharmacist jobs pay per hour?

As of Aug 25, 2026, the average hourly pay for remote prior authorization pharmacist in Springfield, IL is $60.37, according to ZipRecruiter salary data. Most workers in this role earn between $55.53 and $66.73 per hour, depending on experience, location, and employer.

What is a remote prior authorization pharmacist?

A Remote Prior Authorization Pharmacist evaluates medication requests from healthcare providers to ensure they meet insurance coverage criteria. They review patient records, assess clinical guidelines, and approve or deny authorizations based on company policies. Working remotely, they collaborate with physicians, insurance companies, and patients to facilitate access to necessary medications while ensuring cost-effective prescribing. Strong clinical knowledge and familiarity with insurance policies are required for this role.

What are the key skills and qualifications needed to thrive as a remote prior authorization pharmacist?

To thrive as a Remote Prior Authorization Pharmacist, you need strong clinical pharmacy knowledge, attention to detail, and current pharmacist licensure. Experience with prior authorization systems, pharmacy benefit management software, and proficiency in using EHRs and relevant payer platforms is crucial. Exceptional written communication, problem-solving, and time management skills help professionals excel in coordinating with providers and payers remotely. These attributes ensure accurate review and efficient processing of medication requests, leading to better patient outcomes and streamlined healthcare delivery.

What are some common challenges faced by remote prior authorization pharmacists, and how can they be managed?

Remote Prior Authorization Pharmacists often navigate challenges such as high volumes of complex medication requests, frequent updates to insurance policies, and communicating effectively with prescribers and payers through virtual channels. Staying organized and keeping up-to-date with payer criteria and evolving drug formularies is essential. Many employers offer robust training and ongoing support to help pharmacists adapt to these changes and maintain workflow efficiency. By leveraging strong communication and analytical skills, pharmacists can streamline approvals and contribute positively to patient care, even in a remote setting.

What are the most commonly searched types of Prior Authorization Pharmacist jobs in Springfield, IL?

The most popular types of Prior Authorization Pharmacist jobs in Springfield, IL are:

What are popular job titles related to Remote Prior Authorization Pharmacist jobs in Springfield, IL?

For Remote Prior Authorization Pharmacist jobs in Springfield, IL, the most frequently searched job titles are:

What job categories do people searching Remote Prior Authorization Pharmacist jobs in Springfield, IL look for?

The top searched job categories for Remote Prior Authorization Pharmacist jobs in Springfield, IL are:

What cities near Springfield, IL are hiring for Remote Prior Authorization Pharmacist jobs?

Cities near Springfield, IL with the most Remote Prior Authorization Pharmacist job openings:

Remote Prior Authorization Pharmacist jobs near you

Care Review Clinician

Springfield, IL • Remote

AltaStaff, LLC
51 - 200 employees
Learn more about AltaStaff, LLCexternal

$40 - $42/hr

Full-time

Posted 6 days ago

Job description

AltaStaff is a staffing agency currently looking for a Care Review Clinician I to work with our Managed Care Client!

Pay Rate: $40 - 42.00 hourly

Schedule: Monday-Friday 9am-5:30pm CST, Rotating Saturday 7-11am CST, Rotating Holidays

***This is a fully remote role but candidates must have a valid RN license in Illinois***

Position Purpose: Care Review Clinician works with the Utilization Management team primarily responsible for medical necessity/utilization review aimed at providing members with the right care.

  • Assess and analyze clinical service requests (e.g., surgeries, outpatient therapies, DME) using evidence-based MCP/MCG criteria.

  • Verify member benefits and eligibility and Process prior authorization determinations within regulatory timelines

  • Collaborate with multidisciplinary teams

  • Completes/reviews Authorizations, reviewing faxes that can be 50-100 pages long

  • Will be expected to manage 25-30 cases successfully daily.

  • Should be able to quickly and accurately determine whether the criteria meet medical necessity.

  • Provides daily review and evaluation of members that require hospitalization and/or procedures providing prior authorizations and/or concurrent review.

  • Assesses services for Molina Members to ensure optimum outcomes, cost effectiveness and compliance with all state and federal regulations and

  • guidelines.

  • Provides concurrent review and prior authorizations (as needed) according to Molina policy for Molina members as part of the Utilization Management team.

  • Additional duties assigned

Education/Experience: 

  • RN license in IL required

  • Must have 2+ years clinical practice experience (hospital, case management, utilization management)

  • Must have 1-3+ years of hospital or medical clinic, utilization review

  • Must have 2-3 years of Prior Authorization OR Med-Surg experience; Familiarity with Inpatient Medical Necessity

  • Must have solid experience within a clinical setting as RN’s must be able to use their knowledge to extrapolate key information during the authorization process

If you've applied and would like to view your application status, please visit: https://altastaff.zenople.com/login/ALTA

AltaStaff is an Equal Employment Opportunity Employer. We provide equal employment opportunities to all qualified applicants for employment without regard to age, race, color, creed, religion, sex, marital status, national origin, ancestry, citizenship, disability, veteran status, sexual orientation, or any other protected status, in accordance with applicable federal, state, and local laws.

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