Remote Utilization Management Pharmacist

Humana Inc; Concord (NH); On-site; USD 104,000 - 143,000; Full time

Job summary

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

This role involves analyzing the medication care plan, assessing overall utilization, and identifying unusual usage patterns in a remote setting. The position requires a Bachelor's degree or equivalent with less than 5 years of technical experience.

Qualifications

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

Responsibilities

• Completes a review that includes a full analysis of the medication care plan, investigation of overall utilization, and identification of unusual usage patterns.
• Intervenes and advises patients and providers to promote cost effective utilization and quality patient outcomes, as needed.
• Follows established guidelines/procedures.
• Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed.

Education

Bachelor's degree or equivalent

Job description

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

This role involves analyzing the medication care plan, assessing overall utilization, and identifying unusual usage patterns in a remote setting. The position requires a Bachelor's degree or equivalent with less than 5 years of technical experience.