Remote Clinical Pharmacist - Utilization Management

Humana Inc; Jackson (MS); On-site; USD 104,000 - 143,000; Full time

Benefits offered by this job

Remote work

Competitive benefits

Job summary

Humana Inc. is seeking a Utilization Management Clinical Pharmacist 2 to perform medical necessity reviews and comprehensive medication reviews for prescriptions requiring pre-authorization.

The role involves interpreting guidelines, analyzing medication care plans, and making independent decisions within established procedures. This remote, full-time position may require occasional travel to Humana offices for training or meetings; it emphasizes collaboration with providers and patients to

Qualifications

• Bachelor's degree or equivalent with less than 5 years of technical experience.
• Clinical pharmacist responsibilities include medical necessity reviews and pre-authorization decisions.
• Experience in utilization management is desirable.

Responsibilities

• Performs medical necessity and comprehensive medication reviews for prescriptions requiring pre-authorization.
• Interprets guidelines, analyzes medication care plans and determines appropriate actions.
• Intervenes and advises patients and providers to promote cost-effective utilization and quality outcomes.

Education

Bachelor's degree or equivalent

Job description

Humana Inc. is seeking a Utilization Management Clinical Pharmacist 2 to perform medical necessity reviews and comprehensive medication reviews for prescriptions requiring pre-authorization.

The role involves interpreting guidelines, analyzing medication care plans, and making independent decisions within established procedures. This remote, full-time position may require occasional travel to Humana offices for training or meetings; it emphasizes collaboration with providers and patients to