Prior Authorization Pharmacist Advisor (Contract)

Company: N8TiVe Consulting
Location: Dublin
Posted on: March 31, 2026

Job Description:

Job Description About the role We are seeking an experienced Prior Authorization Pharmacist to serve as an advisor and mentor to a mid-career pharmacist reviewer. This role is focused on improving case review productivity, workflow efficiency, and documentation quality across prior authorization and related pharmacy benefit review activities. The ideal candidate brings deep experience in pharmacy benefit review and can help increase sustainable review throughput by up to 3 additional cases per hour, while maintaining strong clinical judgment, compliance, and defensible decision-making. Key responsibilities \t•\tMentor and coach a mid-career pharmacist reviewer in prior authorization workflow optimization \t•\tEvaluate current review processes and identify opportunities to improve speed, accuracy, and consistency \t•\tAdvise on best practices for reviewing pharmacy benefit cases, including prior authorizations, coverage determinations, and appeals \t•\tImprove efficiency in case triage, clinical evaluation, documentation, and decision routing \t•\tDevelop practical workflow tools, templates, and review frameworks to reduce avoidable delays and rework \t•\tSupport measurable gains in productivity without compromising quality, compliance, or audit readiness \t•\tHelp establish performance benchmarks, quality safeguards, and sustainable improvement plans \t•\tShare real-world operational strategies that strengthen reviewer confidence and throughput Ideal candidate \t•\tPharmD required \t•\tActive pharmacist license required \t•\t5 years of experience in prior authorization, utilization management, managed care pharmacy, or pharmacy benefit review \t•\tStrong background in clinical case review, pharmacy benefit interpretation, and documentation \t•\tExperience mentoring, coaching, or developing pharmacists or clinical reviewers \t•\tAbility to identify workflow bottlenecks and recommend clear, practical improvements \t•\tStrong understanding of quality, compliance, and defensible review practices in pharmacy operations Preferred qualifications \t•\tExperience in health plan, PBM, or managed care pharmacy environments \t•\tExperience with prior authorization, appeals, coverage determinations, and formulary exception workflows \t•\tExposure to productivity improvement, QA, audit support, or reviewer calibration initiatives \t•\tStrong communication skills with the ability to mentor in a constructive, performance-oriented manner What success looks like \t•\tA clear assessment of current reviewer workflow and performance opportunities \t•\tImproved review efficiency and more consistent case handling \t•\tSustainable productivity improvement targeting up to 3 additional cases per hour, depending on case mix and workflow constraints \t•\tStronger documentation quality and decision consistency \t•\tA practical playbook for continued reviewer growth and operational performance Engagement structure \t•\tRemote \t•\tFlexible, part-time advisory engagement \t•\tProject-based or hourly consulting arrangement \t•\tIdeal for a senior managed care pharmacist who enjoys mentoring and operational improvement How to apply Please send: \t•\tA brief summary of your prior authorization or managed care pharmacy experience \t•\tExamples of reviewer mentoring, coaching, or workflow improvement work \t•\tRelevant environments supported, such as prior authorization, appeals, or coverage determination \t•\tYour availability and rate

Keywords: N8TiVe Consulting, Pleasanton , Prior Authorization Pharmacist Advisor (Contract), Healthcare , Dublin, California