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.
Remote Pharmacy Prior Authorization & Specialty-Medication Access Specialist - AI Trainer ($75-$75 per hour) • Norman, Oklahoma, US
OverviewPivot Your Rehab Career :Join HealthPro Heritage as a Remote Clinical Analyst!HealthPro Heritage is looking for a motivated Rehab professional - Assistant, Director, or experienced clinicia... Show more
Oklahoma Arthritis Center (OAC) is an Equal Employment Opportunity employer and considers all applicants without regard to race, religion, color, sex, national origin, age, disability, veteran stat... Show more
Are you interested in working flexible hours, connecting with people one-on-one, and helping them re-engage with their health? At Signify Health, part of CVS Health®, our mission is to build.We’re ... Show more
We are urgently seeking people interested in taking market research studies for well known brands.If you are a self-starter, looking for flexible hours throughout the week, this may be for you! Ear... Show more
Certified Medical Assistant - Correctional Nursing.Supplemental Health Care is a national hiring partner for facilities across the United States.Our Correctional Health and Government Services divi... Show more
Advanced Certified Medical Aide (ACMA).We are looking for outstanding individuals to join the nursing team as an Advanced Certified Medication Aide (A.You will make a difference in the lives of res... Show more
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
Remote Jobs are now available in your area.This position is a work from home position.You will not need to come into the office.Benefits: Health Insurance, 401K, Vacation& PTO.Apply now! Work f... Show more
Utilizes evidence-based practice to support clinical interventions.Provides rehabilitative, skilled and medically necessary treatment intervention to patients with physical functioning disorders pe... Show more
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
Senior Product ManagerAt OneStudyTeam, we specialize in speeding up clinical trials and increasing the chance of new therapies being approved with the ultimate goal of improving patient outcomes.Ou... Show more
Voca Healthcare is seeking a travel nurse RN Psychiatric for a travel nursing job in Edmond, Oklahoma.Job Description & Requirements Specialty:Psychiatric Discipline:RN Duration:13 weeks 36 hou... Show more
Oklahoma Arthritis Center (OAC) is an Equal Employment Opportunity employer and considers all applicants without regard to race, religion, color, sex, national origin, age, disability, veteran stat... Show more
Purcell, Oklahoma, United States.Join VitalCaring Where Your Passion Changes Lives!.Are you looking for a career where compassion meets purpose? At VitalCaring, we're more than a home health and ho... Show more
LanceSoft is seeking a travel nurse RN Behavioral Health for a travel nursing job in Edmond, Oklahoma.Job Description & Requirements Specialty:Behavioral Health Discipline:RN Duration:13 weeks ... Show more
Are you interested in working flexible hours, connecting with people one-on-one, and helping them re-engage with their health? At Signify Health, part of CVS Health®, our mission is to build.We’re ... Show more
It's fun to work in a company where people truly believe in what they're doing! We're committed to bringing passion and customer focus to the business.Manager, Applied AI is responsible for leading... Show more
Qualified Medication Aide - Correctional Nursing.Supplemental Health Care is a national hiring partner for facilities across the United States.Our Correctional Health and Government Services divisi... Show more
We're looking for a reliable and professional Medical Courier to transport time-sensitive medical materials — including lab specimens, pharmaceuticals, medical equipment, and patient records — betw... Show more
Specializing in primary care for patients 65+ is our passion.Are you looking for a career opportunity that will help you grow personally and professionally?.Do you have a passion for helping others... Show more
