Remote Utilization Management Clinical Pharmacist

Humana Inc; Atlanta (GA); On-site; USD 104,000 - 143,000; Full time

Job summary

The Utilization Management Clinical Pharmacist 2 (VSP/PT) at Humana Inc. performs medical necessity reviews and comprehensive medication assessments for prescriptions requiring pre-authorization, guiding decisions with minimal supervision.

This remote role involves analyzing medication care plans, monitoring overall utilization, and advising patients and providers to promote cost-effective care and high-quality outcomes, within Humana's guidelines and objectives.

Qualifications

• Typically requires Bachelor's degree or equivalent and less than 5 years of technical experience

Responsibilities

• Completes medical necessity and comprehensive medication reviews for prescriptions requiring pre-authorization
• Performs full analysis of the medication care plan, investigates overall utilization and unusual usage patterns
• Intervenes and advises patients and providers to promote cost effective utilization and quality patient outcomes
• Follows established guidelines/procedures

Education

Bachelor's degree or equivalent

Job description

The Utilization Management Clinical Pharmacist 2 (VSP/PT) at Humana Inc. performs medical necessity reviews and comprehensive medication assessments for prescriptions requiring pre-authorization, guiding decisions with minimal supervision.

This remote role involves analyzing medication care plans, monitoring overall utilization, and advising patients and providers to promote cost-effective care and high-quality outcomes, within Humana's guidelines and objectives.