Remote Utilization Management Clinical Pharmacist

Humana Inc; Denver (CO); On-site; USD 104,000 - 143,000; Full time

Benefits offered by this job

Remote work option

Travel for training or meetings

Job summary

Humana Inc. is seeking a Utilization Management Clinical Pharmacist 2 to perform medical necessity reviews and comprehensive medication assessments for pre-authorization. The role involves interpreting complex care plans and advising on cost-effective utilization while aligning with organizational objectives.

Responsibilities include case reviews, clinical interventions, and guidance to patients and providers, with remote work options and occasional travel for training or meetings.

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.
• 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

Humana Inc. is seeking a Utilization Management Clinical Pharmacist 2 to perform medical necessity reviews and comprehensive medication assessments for pre-authorization. The role involves interpreting complex care plans and advising on cost-effective utilization while aligning with organizational objectives.

Responsibilities include case reviews, clinical interventions, and guidance to patients and providers, with remote work options and occasional travel for training or meetings.