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© All Rights Reserved. ApplyBlast.com
Healthfirst
The Clinical UM Pharmacist reviews prior authorizations for medications under the medical benefit and collaborates with prescribing physicians and Medical Directors to discuss clinical rationale. The role involves developing clinical criteria and medical policies, conducting drug utilization reviews, and ensuring compliance with CMS and NYSDOH regulations. This position requires maintaining current knowledge of evidence-based medicine and specialty pharmaceuticals to support quality assurance and efficient utilization management.
Headquarters
New York, New York, United States
Company Size
1001-5000 employees
Founded
1993
Healthfirst is a New York-based health insurer offering Medicare Advantage, Medicaid, Essential Plans, Child Health Plus, and other individual and family plans, along with long-term care options. Serving New York City, Long Island, Westchester, Rockland, Sullivan and surrounding areas, Healthfirst emphasizes a broad provider network, care coordination, and member resources to help New Yorkers access affordable health coverage.