Medication Access Specialist – Remote, $75/hr

About the role

We are looking for a Medication Access Specialist to join our remote team. The role focuses on managing prior authorisation requests for high‑cost and specialty medications, ensuring patients receive timely access while maintaining compliance with payer requirements.

Key responsibilities

• Process and manage prior authorisation requests for specialty medications, biologics, and high‑cost pharmaceuticals across commercial, Medicare Part D, and Medicaid payers.
• Review clinical documentation and pharmacy benefit criteria to determine medical necessity for drug authorisations.
• Evaluate AI‑generated prior authorisation recommendations for accuracy, completeness, and payer compliance.
• Coordinate with prescribers, specialty pharmacies, and payers to obtain timely medication authorisations.
• Manage appeals for denied authorisations, including peer‑to‑peer requests and exception processes.
• Annotate AI outputs and provide structured feedback to support AI training datasets.

Required profile

• 5+ years of experience in pharmacy prior authorisation, specialty medication access, or pharmacy benefit management.
• Deep knowledge of specialty drug formularies, step‑therapy protocols, and payer PA criteria for commercial and government payers.
• Experience with specialty pharmacy platforms and pharmacy benefit management (PBM) systems.
• Familiarity with Medicare Part D coverage determination and exception processes.
• Excellent written and verbal English communication skills and strong attention to detail.

Required skills

• Pharmacy Benefit Management (PBM) systems
• Specialty pharmacy platforms
• AI evaluation tools

What we offer

• Contract position with competitive hourly rate up to $75.
• Fully remote work arrangement.
• Opportunity to work with cutting‑edge AI tools in a fast‑growing AI research environment.