Clinical Pharmacist Operations Leader, UM Platform

Career Opportunities; Brentwood (TN); On-site; USD 120,000 - 180,000; Full time

Job summary

TruDataRx, Inc. seeks a Clinical Pharmacist Operations Manager to lead day-to-day utilization management clinical operations, ensuring accurate adjudication, regulatory compliance, and adherence to turnaround-time SLAs across prior authorizations and appeals.

This role also serves as the primary business owner for the UM platform, governing workflow design, decision-tree configuration, and cross-functional collaboration to optimize efficiency and accuracy.

Responsibilities

• Lead daily UM Pharmacist operations ensuring compliant, timely adjudication of prior authorizations and appeals.
• Oversee clinical workload distribution, shift coverage, and capacity planning to meet SLA targets.
• Collaborate with intake teams to ensure seamless end-to-end coordination between front-line and clinical review queues.
• Oversee governance and configuration of the Utilization Management platform, including decision-tree testing and UAT.
• Mentor Clinical Pharmacist Supervisors and QA & Training Specialist; drive continuous professional development.

Job description

TruDataRx, Inc. seeks a Clinical Pharmacist Operations Manager to lead day-to-day utilization management clinical operations, ensuring accurate adjudication, regulatory compliance, and adherence to turnaround-time SLAs across prior authorizations and appeals.

This role also serves as the primary business owner for the UM platform, governing workflow design, decision-tree configuration, and cross-functional collaboration to optimize efficiency and accuracy.