Remote Utilization Management Pharmacist

Humana; United States; On-site; 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 insurance

Job summary

Humana is seeking a Utilization Management Clinical Pharmacist 2 to perform medical necessity and comprehensive medication reviews for prescriptions requiring pre-authorization. This remote role involves interpretation and independent decision-making to determine appropriate action within established guidelines.

The position emphasizes cost-effective utilization and quality patient outcomes, with occasional travel to Humana offices for training. Travel is optional; base on USA.

Qualifications

• 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 and applies independent judgment with minimal direction.

Education

Bachelor's degree or equivalent

Job description

Humana is seeking a Utilization Management Clinical Pharmacist 2 to perform medical necessity and comprehensive medication reviews for prescriptions requiring pre-authorization. This remote role involves interpretation and independent decision-making to determine appropriate action within established guidelines.

The position emphasizes cost-effective utilization and quality patient outcomes, with occasional travel to Humana offices for training. Travel is optional; base on USA.