Pharmacy Prior Authorization Specialist

About OpenTrain

OpenTrain is the #1 platform for finding and building careers in AI training and data labeling. OpenTrain AI hires and contracts specialists to help improve the systems behind modern artificial intelligence, giving contributors a way to build credible experience in a fast-growing field.

• Create a free OpenTrain account and apply in minutes
• Build a professional profile around your AI training experience
• Find flexible opportunities that match your specialized skills

About AI Training in Healthcare

AI training is the human work behind better artificial intelligence. Subject-matter experts review documents, assess model outputs, and provide structured feedback so AI systems can produce more accurate and useful results in specialized workflows such as pharmacy and healthcare.

• Evaluate AI-generated recommendations against real-world standards
• Identify errors, omissions, and compliance issues
• Provide feedback that helps improve future AI outputs

The Role

OpenTrain is hiring a Pharmacy Prior Authorization Specialist to review specialty medication prior authorization requests and evaluate AI outputs for accuracy, completeness, and payer compliance. The work focuses on drug formularies, step therapy, medical necessity review, appeals, and structured feedback for healthcare AI training datasets.

You will also coordinate with prescribers, specialty pharmacies, and payers to help validate medication access decisions. This is an intermediate-level, part-time contractor role for candidates in the United States who can commit to 20 or more hours per week.

• Pay: $75 per hour
• Engagement: Part-time contractor
• Location: United States
• Language: English
• Time requirement: 20+ hours per week
• Data type: Documents

What You'll Do

• Review clinical documentation and pharmacy benefit criteria for specialty drug authorizations
• Evaluate AI-generated pharmacy prior authorization recommendations for accuracy and payer compliance
• Coordinate with prescribers, specialty pharmacies, and payers on medication authorizations
• Manage appeals for denied pharmacy authorizations, including peer-to-peer requests and exception processes
• Track authorization status, approval rates, and denial trends to identify process improvements
• Annotate AI outputs and provide structured feedback for AI training datasets

Required Qualifications

This role requires substantial experience with specialty medication access and pharmacy benefit processes. You should be comfortable reviewing clinical documentation, applying payer criteria, and assessing whether AI-generated pharmacy content is accurate and complete.

• 5+ years of experience in pharmacy prior authorization, specialty medication access, or pharmacy benefit management
• Experience processing pharmacy prior authorization requests for specialty medications
• Strong knowledge of specialty drug formularies, step therapy protocols, and payer prior authorization criteria
• Familiarity with Medicare Part D coverage determinations and exception processes
• Experience with specialty pharmacy platforms and pharmacy benefit management systems
• Exceptional written and verbal English communication skills
• Strong attention to detail when evaluating clinical documentation and AI-generated outputs

Preferred Background

• Certified Pharmacy Technician, or CPhT, credential
• Certified Prior Authorization Professional, or CPAP, credential
• Experience with hub services and patient assistance programs for specialty medications
• Background in specialty pharmacy, infusion services, oncology, or rheumatology drug access
• Familiarity with AI tools and evaluating AI-generated pharmacy content
• Experience with manufacturer copay assistance and patient access programs

Why Work With OpenTrain

Every major AI system depends on people who can bring practical expertise, careful judgment, and domain knowledge to training data. This role lets you apply your pharmacy prior authorization experience to cutting-edge AI work while contributing to systems used in healthcare workflows.

OpenTrain helps you build a lasting profile around your AI training and data-labeling work. As you contribute, your profile can showcase relevant experience and help you discover additional opportunities aligned with your expertise.

• Apply your pharmacy knowledge to emerging AI technology
• Work remotely with flexible part-time scheduling
• Build a durable portfolio of specialized AI training experience
• Contribute structured feedback that supports better healthcare AI

How to Apply

Create a free account on OpenTrain, complete your profile, and apply for the Pharmacy Prior Authorization Specialist contract. Be prepared to highlight your experience with specialty medication authorizations, payer criteria, Medicare Part D processes, and clinical documentation review.

• Confirm that you are located in the United States
• Showcase your pharmacy prior authorization experience
• Highlight any CPhT or CPAP credentials
• Indicate your availability for 20+ hours per week