Remote Utilization Management Pharmacist

Humana; United States; Remote; USD 104,000 - 143,000; Full time

Benefits offered by this job

Paid time off

401(k) retirement savings plan

Employee assistance program

Business travel and accident

Job summary

Humana is seeking a Utilization Management Clinical Pharmacist 2 (VSP/PT) to perform medical necessity reviews and comprehensive medication reviews for prescriptions requiring pre-authorization. The role involves analyzing care plans, identifying unusual usage patterns, and advising patients and providers to promote cost-effective utilization and quality outcomes.

The position is remote with occasional travel to Humana offices for training or meetings, and focuses on ensuring effective

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.

Education

Bachelor’s degree or equivalent

Job description

Humana is seeking a Utilization Management Clinical Pharmacist 2 (VSP/PT) to perform medical necessity reviews and comprehensive medication reviews for prescriptions requiring pre-authorization. The role involves analyzing care plans, identifying unusual usage patterns, and advising patients and providers to promote cost-effective utilization and quality outcomes.

The position is remote with occasional travel to Humana offices for training or meetings, and focuses on ensuring effective