Remote Clinical Pharmacist - Utilization Management

CommunityCare; Tulsa (OK); Remote; USD 110,000 - 150,000; Full time

Benefits offered by this job

Remote work option

Job summary

CommunityCare in the United States is seeking an experienced Utilization Management Clinical Pharmacist to optimize medication use and improve member outcomes. The role supports medical injectable and specialty drug utilization, formulary development, clinical policy creation, and related clinical pharmacy initiatives.

The position emphasizes evidence-based, cost-conscious therapy while aligning with regulatory compliance and organizational quality goals.

Qualifications

• Knowledge of managed care pharmacy and formulary management principles.
• Ability to interpret clinical literature, treatment guidelines, and regulatory requirements.
• Strong analytical, organizational, and communication skills.

Responsibilities

• Review prior authorization requests for medical injectable, specialty, and high-cost meds using criteria and regulatory requirements.
• Approve or deny requests within established turnaround times.
• Collaborate with technicians and clinicians to support utilization management decisions.
• Provide clinical consultation on complex medication requests and coverage determinations.
• Develop and maintain clinical criteria, treatment policies, and prior authorization guidelines.
• Monitor new drug approvals and suggest utilization management strategies.
• Create educational materials for providers and internal stakeholders.
• Participate in provider outreach and academic detailing on evidence-based prescribing.

Skills

Managed care pharmacy

Utilization management

Formulary management

Analytical skills

Communication skills

Team collaboration

Education

PharmD or BS in Pharmacy

Active, unrestricted pharmacist license (US)

Tools

Microsoft Office

Pharmacy information systems

Job description

CommunityCare in the United States is seeking an experienced Utilization Management Clinical Pharmacist to optimize medication use and improve member outcomes. The role supports medical injectable and specialty drug utilization, formulary development, clinical policy creation, and related clinical pharmacy initiatives.

The position emphasizes evidence-based, cost-conscious therapy while aligning with regulatory compliance and organizational quality goals.