United States onlySagility combines industry-leading technology and transformation-driven BPM services with decades of healthcare domain expertise to help clients draw closer to their members. The company optimizes the entire member/patient experience through service offerings for clinical, case management, member engagement, provider solutions, payment integrity, claims cost containment, and analytics. Sagility has more than 25,000 employees across 5 countries.
Job title:
Job Description:
Elevate Your Career with Sagility
Sagility, a global leader in business process management, is dedicated to enhancing the member and patient experience. By combining cutting-edge technology with decades of healthcare expertise, we deliver exceptional results for our clients.
Become Part of a Team That S.O.A.R,s!
- S Spark Curiosity
- O One Team, One Direction
- A Action for Results
- R Right by Right Purpose
Use your clinical expertise without the retail environment
Looking to apply your PharmD in a role that values your clinical judgment, analytical thinking, and attention to detail? Join Sagility and be part of a team that supports critical healthcare decisions behind the scenes.
In this full-time, non-patient-facing role, you’ll review medication requests and apply clinical guidelines to ensure members receive appropriate, evidence-based care. If you enjoy solving complex clinical scenarios, working independently, and contributing to meaningful healthcare outcomes, this opportunity is for you.
Benefits You Will Enjoy
- Competitive pay: $52.00/hour
- Performance-based incentives
- Paid training in a cutting-edge virtual training environment
- Comprehensive health coverage
- Employee wellness and engagement programs.
What You Will Do
- Evaluate clinical requests such as: Prior Authorizations (PA), Formulary Exceptions (FE), Step Therapy (ST) requests, Quantity Limit (QL) exceptions
- Apply clinical guidelines and client criteria to determine coverage decisions
- Interpret complex clinical scenarios and provide clear documentation supporting decisions
- Collaborate with pharmacists and team members to ensure consistency and accuracy
- Consult with healthcare providers when clarification is needed regarding clinical requests
- Meet productivity and quality benchmarks while maintaining strong attention to detail
- Support a culture focused on accuracy, accountability, and continuous learning
What Makes You a Great Fit
- Doctor of Pharmacy (PharmD) degree
- Active pharmacist license in good standing
- 2–3 years of experience supporting U.S. healthcare pharmacy or utilization management processes preferred
- Strong clinical judgment and problem-solving skills
- Comfortable working independently in a structured environment
- Strong written communication and documentation skills
- Ability to learn new systems quickly and manage multiple applications simultaneously
- Detail-oriented with strong focus on accuracy and quality
- Hardwired internet connection with minimum speeds of 25 Mbps download and 10 Mbps upload
- Secure, private workspace free from distractions
Work Environment & Schedule
- Work from Home
- Full-time position supporting a volume-driven healthcare environment
- Core business hours: 8:00 AM – 6:00 PM Central Time
Schedules may vary based on business needs - Flexibility required for:
• Occasional overtime
• Weekend rotation (typically every 4–6 weeks)
• Select holidays (2–3 annually) - Structured training program (approximately 5 weeks) to ensure confidence and success in the role
What Success Looks Like
- High-quality clinical decision-making
- Consistent productivity aligned with team benchmarks
- Strong attention to detail and documentation accuracy
- Reliability, accountability, and professionalism
- Collaborative mindset and willingness to learn
Benefits & Perks
• Daily Pay options available
• Medical, Dental, and Vision coverage
• Life Insurance
• Short-Term and Long-Term Disability options
• Flexible Spending Account (FSA)
• Employee Assistance Program
• 401(k) with employer contribution
• Paid Time Off (PTO)
• Tuition Reimbursement
Sagility is an Equal Opportunity Employer/Veteran/Disability.
As a work-from-home team member, you are required to participate in active camera sessions for your role. You will be expected to remain on camera throughout onboarding and training and be available on camera as needed once in production. This is a standard requirement for the position; failure to meet this expectation will result in separation from employment.
Alert: Please beware of fraudulent communications from profiles impersonating Sagility or its employees. All official communication from Sagility will come from our verified email domains: “@sagility.com” or “@sagilityhealth.com”. Sagility will never ask for payments for job offers, interviews, or otherwise. Do not respond to suspicious communications, whether via email, WhatsApp, or any social platform. For any concerns, contact us directly through our official website.
AU, CA + 8 more
