Medication Access Specialist - Fully Remote | Upto $75/hr

About the job

Mercor connects elite creative and technical talent with leading AI research labs. Headquartered in San Francisco, our investors include Benchmark , General Catalyst , Peter Thiel , Adam D'Angelo , Larry Summers , and Jack Dorsey .

Position: Pharmacy Prior Authorization & Specialty-Medication Access Specialist
Type: Contract
Compensation: $75/hour
Location: Remote
Role Responsibilities

- Process and manage prior authorisation requests for speciality 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 speciality drug authorisations.

- Evaluate AI-generated pharmacy prior authorisation recommendations for accuracy, completeness, and payer compliance.

- Coordinate with prescribers, speciality pharmacies, and payers to obtain timely medication authorisations.

- Manage appeals for denied pharmacy authorisations, including peer-to-peer requests and exception processes.

- Annotate AI outputs and provide structured feedback to support AI training datasets .

Qualifications

Must-Have

- 5+ years of experience in pharmacy prior authorisation, speciality medication access, or pharmacy benefit management.

- Deep knowledge of speciality drug formularies, step therapy protocols, and payer PA criteria across commercial and government payers.

- Experience with speciality pharmacy platforms and pharmacy benefit management ( PBM ) systems.

- Familiarity with Medicare Part D coverage determination and exception processes.

- Exceptional written and verbal English communication skills.

- High attention to detail with the ability to evaluate clinical documentation and AI-generated outputs.

Preferred

- Certified Pharmacy Technician (CPhT) or Certified Prior Authorisation Professional (CPAP) credential.

- Experience with hub services and patient assistance programs for speciality medications.

- Background in speciality pharmacy, infusion services, or oncology/rheumatology drug access.

- Familiarity with AI tools and comfort evaluating AI-generated pharmacy content.

- Experience with manufacturer copay assistance and patient access programs.

Application Process (Takes 20–30 mins to complete)

- Upload resume

- AI interview based on your resume

- Submit form

Resources & Support

- For details about the interview process and platform information, please check:

- For any help or support, reach out to:

PS: Our team reviews applications daily. Please complete your AI interview and application steps to be considered for this opportunity.

Originally posted on Himalayas