Remote Lead Utilization Pharmacist – Prior Authorization

Judi Health, LLC; Jersey City (NJ); Remote; USD 134,000 - 146,000; Full time

Job summary

Judi Health, LLC is seeking a Lead Utilization Management Pharmacist to oversee daily clinical pharmacy functions, including prior authorization reviews and education for members and providers. You will guide staff, drive quality improvements, and ensure compliance with contractual criteria.

The role requires an active pharmacist license and a PharmD or BS in Pharmacy with 2+ years of experience. Remote work from the US with ET shift and weekend/holiday rotation is expected.

Qualifications

• Active, unrestricted pharmacist license.
• Bachelor's or Doctor of Pharmacy Degree.
• 2+ years of pharmacy practice experience.
• Experience in customer service, call center and prior authorization.
• Excellent communication, writing, and organizational skills.
• Ability to work remotely in a high-volume, metric-driven environment.

Responsibilities

• Oversee day-to-day clinical pharmacy functions including prior authorization and appeal reviews and provider education.
• Support training and development of staff to enhance skills.
• Contribute to quality improvement initiatives and optimize workflows.
• Collaborate with partners to ensure consistency in processes and compliance.
• Lead projects to improve pharmacy operations and clinical outcomes.
• Provide SME guidance on clinical reviews and act as a consultant to providers and staff.
• Maintain turnaround time and monitor regulatory and internal compliance requirements.
• Serve as backup to call center team and assist with proactive outreach.
• Review pharmacy claims data to identify trends and opportunities for improvement.

Skills

Pharmacist license

Communication

Organization

Remote work

Multitasking

Education

Bachelor's or Doctor of Pharmacy Degree

Tools

MS Office

Job description

Judi Health, LLC is seeking a Lead Utilization Management Pharmacist to oversee daily clinical pharmacy functions, including prior authorization reviews and education for members and providers. You will guide staff, drive quality improvements, and ensure compliance with contractual criteria.

The role requires an active pharmacist license and a PharmD or BS in Pharmacy with 2+ years of experience. Remote work from the US with ET shift and weekend/holiday rotation is expected.