Remote Utilization Management Pharmacist: Medication Review

Humana Inc; Bismarck (ND); 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 pre-authorizations, with independent decision making as needed.

The role involves analyzing medication care plans, evaluating utilization, and advising patients and providers to promote cost-effective care and quality outcomes, with travel to Humana offices occasionally.

Qualifications

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

Responsibilities

• A clinical pharmacist who completes medical necessity and comprehensive medication reviews for prescriptions requiring pre-authorization.
• 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.

Skills

Clinical pharmacist

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 pre-authorizations, with independent decision making as needed.

The role involves analyzing medication care plans, evaluating utilization, and advising patients and providers to promote cost-effective care and quality outcomes, with travel to Humana offices occasionally.