[Hiring] Specialty Medication Prior Authorization Consultant @24-MAG

Role Description

We are sharing a specialised part-time consulting opportunity for United States-based pharmacy and healthcare access professionals experienced in:

• Pharmacy prior authorization
• Specialty medication access
• Payer coverage criteria
• Step therapy requirements
• Medicare Part D coverage determinations
• Pharmacy benefit management
• Patient access workflows

This role supports current and upcoming remote consulting opportunities focused on:

• AI-assisted pharmacy prior authorization evaluation
• Specialty medication access review
• Payer criteria assessment
• High-quality project execution

Selected professionals will apply pharmacy access expertise to:

• Evaluate AI-generated prior authorization recommendations
• Review clinical documentation support
• Identify payer compliance issues
• Provide structured feedback based on detailed project criteria

Qualifications

• 5+ years of experience in pharmacy prior authorization, specialty medication access, pharmacy benefit management, medication access operations, or related healthcare access workflows
• Deep knowledge of specialty drug formularies, step therapy protocols, payer prior authorization criteria, and coverage requirements across commercial and government payers
• Experience with specialty pharmacy platforms, pharmacy benefit management systems, and medication access workflows
• Familiarity with Medicare Part D coverage determination and exception processes
• Strong ability to review clinical documentation and determine whether payer authorization requirements are met
• Exceptional written and verbal English communication skills
• High attention to detail and ability to evaluate clinical documentation, payer criteria, and AI-generated pharmacy outputs
• Ability to work independently in a remote, project-based environment

Requirements

• Professional background in pharmacy prior authorization, specialty pharmacy, pharmacy benefit management, medication access, patient access, infusion services, hub services, or payer authorization workflows
• Experience in specialty pharmacy, health systems, provider groups, payer environments, PBM operations, oncology access, rheumatology access, or high-cost medication workflows
• Practical experience with pharmacy authorization platforms, PBM systems, payer portals, clinical documentation review, and medication access processes
• Formal education or training in pharmacy, healthcare administration, health information management, nursing, life sciences, or a related healthcare field may be relevant depending on project scope

Benefits

• Apply pharmacy prior authorization and specialty medication access expertise to structured remote healthcare project work
• Contribute to high-quality AI-assisted pharmacy benefit and medication access evaluation
• Use payer criteria knowledge, documentation review skills, and specialty drug workflow experience in a focused review environment
• Work on flexible assignments aligned with pharmacy access, prior authorization, specialty medication, and payer workflow expertise
• Remote structure with competitive hourly compensation

Contract Details

• Independent contractor role
• Fully remote with flexible scheduling
• United States-based professionals are required for this opportunity
• Part-time project-based commitment depending on availability, onboarding status, and project needs
• Competitive rates of up to $55 per hour depending on pharmacy access experience, prior authorization expertise, specialty medication background, and project scope
• Weekly payments via Stripe or Wise
• Projects may be extended, shortened, or adjusted depending on scope and performance
• Work will not involve access to confidential or proprietary information from any employer, client, or institution