Talent.com
Mercor
Remote Pharmacy Prior Authorization & Specialty-Medication Access Specialist - AI Trainer ($75-$75Mercor • St. Paul, Minnesota, US
Remote Pharmacy Prior Authorization & Specialty-Medication Access Specialist - AI Trainer ($75-$75

Remote Pharmacy Prior Authorization & Specialty-Medication Access Specialist - AI Trainer ($75-$75

Mercor • St. Paul, Minnesota, US
30+ days ago
Salary
$75.00 hourly
Job type
  • Full-time
  • Remote
Job description
Mercor is working with a leading AI research lab to improve the capabilities of next-generation AI systems. We are seeking experienced Medication and Pharmacy Prior Authorisation specialists with expertise in speciality medication access to evaluate AI tools designed to automate pharmacy benefit management and speciality drug authorisation workflows. Your deep knowledge of drug formularies, step therapy, and payer PA criteria will directly shape AI systems that improve patient access to critical therapies. **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. - Navigate payer formularies, step therapy requirements, and speciality drug coverage policies. - Track authorisation status, approval rates, and denial trends to identify process improvement opportunities. - Ensure compliance with payer-specific pharmacy benefit requirements and CMS Part D guidelines. - Annotate AI outputs and provide structured feedback to support AI training datasets. **Requirements** - 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 Qualifications** - 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. **Why Join?** - Contribute to the development of frontier AI systems in healthcare. - Collaborate with a world-class AI research organisation. - Gain exposure to cutting-edge AI workflows in healthcare revenue cycle management. - Opportunity to work on high-impact projects shaping the future of healthcare AI.
Create a job alert for this search

Remote Pharmacy Prior Authorization & Specialty-Medication Access Specialist - AI Trainer ($75-$75 per hour) • St. Paul, Minnesota, US

Similar jobs

Insurance Authorization Specialist- Remote Must Reside in MN or WI

Nystrom & Associates, Ltd.Saint Paul, MN, United States
Remote
Full-time

We are committed to helping patients in our community who are experiencing personal, emotional, marriage, family or psychological problems.Founded in 1991, we offer an intensive outpatient chemical... Show more

 • Promoted

MTM Pharmacy Support Coordinator Remote / Hybrid

Park Nicollet Health ServicesSaint Paul, MN, United States
Remote
Full-time

A healthcare organization in Minnesota is seeking a Coordinator for Medication Therapy Management to support pharmacy operations.The role involves assisting patients with specialty medications and ... Show more

 • Promoted

Travel Nurse RN - Operating Room in Wyoming, MN

TravelNurseSourceWyoming, MN, US
Full-time

Registered Nurse (RN) | Operating Room.Competitive weekly pay (inquire for details) .TravelNurseSource is working with TNAA | TotalMed to find a qualified OR RN in Wyoming, Minnesota, 55092!.Travel... Show more

 • Promoted

Supervisor, Medication Access Specialist - Pacific Standard Time/ Mountain Standard Time

VisanteSaint Paul, MN, United States
Full-time

Medication Access Specialist Supervisor.We are relentless in solving the most complex challenges in health system pharmacydesigning pharmacy footprints that meet our clients where they are today an... Show more

 • Promoted

Admissions Specialist - Remote

Accanto HealthSaint Paul, MN, United States
Remote
Full-time

Admissions Specialist - RemoteSaint Paul, Minnesota, United StatesOur vision is a world of peaceful relationships with food, weight, and body image, where everyone with an eating disorder can exper... Show more

 • Promoted

Remote Medical Authorization Specialist

EbenezerSaint Paul, MN, United States
Remote
Full-time

A health services organization is seeking a Revenue Cycle Management specialist to secure necessary medical approvals and manage authorization requests.Responsibilities include reviewing medical hi... Show more

 • Promoted

Director Market Access (Reimbursement Development, Coverage Expansion, Medicaid) REMOTE

BaxterSaint Paul, MN, United States
Remote
Full-time

This is where you save and sustain livesAt Baxter, we are deeply connected by our mission.No matter your role at Baxter, your work makes a positive impact on people around the world.You'll feel a s... Show more

 • Promoted

Remote Data Entry Specialist

Focus Group PanelCircle Pines, MN, United States
Remote
Part-time

Work From Home, Entry Level Data Entry Clerk As A Research Participant We are looking for people who want to work remotely from home.Youll need an Internet connection and a mobile device or compute... Show more

 • Promoted

Travel Nurse RN - Operating Room - $2,694 per week in Wyoming, MN

TravelNurseSourceWyoming, MN, US
$2,694.00 weekly
Full-time

Registered Nurse (RN) | Operating Room.TravelNurseSource is working with FlexCare to find a qualified OR RN in Wyoming, Minnesota, 55092!.Call-off Policy Log in to view.First Offer = Best Offer Gua... Show more

 • Promoted

Flexible remote AI work. Your schedule. Paid weekly, straight to your bank account.

Meridian.aiRosemount, MN, US
Remote
Full-time

Review and label digital content including text, images, and documents.Every task you complete helps improve how technology interprets information and performs in practical settings.Detail-oriented... Show more

 • Promoted

(Remote) Strategic Pharmacy Consultant

NFP CorpSaint Paul, MN, United States
Remote
Full-time

OverviewWho We Are :NFP, an Aon company, is a multiple Best Places to Work award winner in Business Insurance.We are an organization of consultative advisors and problem solvers.We help companies a... Show more

 • Promoted

Access Manager

Northstar Behavioral HealthSaint Paul, MN, United States
Full-time

Join A Team That Changes LivesIncluding Yours!.Northstar Behavioral Health Network is a team of professionals that specialize in serving those battling substance use disorders, specifically Opioid ... Show more

 • Promoted

Access & Reimbursement Manager (ARM) Immunology - MINNEAPOLIS, MN

NovartisSaint Paul, MN, United States
Full-time

Access & Reimbursement Manager, NPS Immunology.The Access & Reimbursement Manager, NPS Immunology MINNEAPOLIS, MN geography.This is a remote & field-based role that covers the following but not lim... Show more

 • Promoted

Prior Authorization Specialist

Gillette Children'sSaint Paul, MN, United States
Full-time

Prior Authorization Specialist1.FTE (40 hrs/wk); Monday Friday, business hours.This position requires initial on-site training at the 455 location in St.Paul, and then will transition to a remote w... Show more

 • Promoted

Credentialing Supervisor - Remote

OptumCircle Pines, MN, United States
Remote
Full-time

Credentialing SupervisorOptum is a global organization that delivers care, aided by technology to help millions of people live healthier lives.The work you do with our team will directly improve he... Show more

 • Promoted

Remote Product Tester - Flexible Studies

BuzzTestersLindstrom, MN
Remote
Full-time

Earn up to $400/week, depending on the number and type of studies you complete.Share honest feedback on products and services from independent brands.Assignments include short online surveys (10–20... Show more

 • Promoted

Trained Medication Assistant / TMA / CMA

Presbyterian Homes & ServicesCottage Grove, MN, United States
Full-time +1

Norris Square Medication Assistant.Put Your Purpose To Work at PHS We Have a Place for YOU Apply To Norris Square Today! At Norris Square find purpose and passion in your work with a team of like... Show more

 • Promoted

Clinical Trial Participants Needed - Earn Up to $4,000 Part-Time

Apex Focus Group LLCSaint Paul, MN, United States
Part-time

Looking to earn extra income while contributing to medical advancements? Explore local clinical trials and get paid up to $4,000 for your participation.No-cost study-related care and medication pro... Show more

 • Promoted

Travel Nurse RN - Operating Room - $2,869 to $3,016 per week in Wyoming, MN

TravelNurseSourceWYOMING, MN, US
$2,869.00 weekly
Full-time

Registered Nurse (RN) | Operating Room.TravelNurseSource is working with AMN Healthcare to find a qualified OR RN in WYOMING, Minnesota, 55092!.Job Description & Requirements.Registered Nurse –... Show more

 • Promoted

Trained Medication Aide TMA

CassiaSaint Paul, MN, United States
Full-time +1

Harmony Gardens is hiring Trained Medication Aides (TMAs) to join our team in our building in Maplewood, MN.If you're looking for a supportive team and a place to grow your career, this is your opp... Show more