Humana

Staff Utilization Management Clinical Pharmacist (VSP/PT)

Humana(1 month ago)

RemotePart TimeSenior$104,000 - $143,000Pharmacy Utilization Management
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About this role

The Staff Utilization Management Pharmacist is a clinical expert who conducts medical necessity and comprehensive medication reviews for prescriptions requiring prior authorization, evaluating complex clinical scenarios and applying evidence-based criteria. This remote, variable-hour position supports utilization management to ensure appropriate medication use and high-quality patient outcomes.

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Required Skills

  • Medication Review
  • Medical Necessity
  • Utilization Management
  • Clinical Evaluation
  • Decision Support
  • PBM Platforms
  • EHRs
  • Microsoft Office
  • Communication
  • Problem Solving

+1 more

Qualifications

  • Bachelor's Degree
  • Doctor of Pharmacy (Pharm.D.)
  • Active Pharmacist License
  • Medicare/Medicaid Participation Eligibility
Humana

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