Remote Utilization Management Pharmacist Medication Reviews

Humana Inc; Augusta (ME); On-site; USD 104,000 - 143,000; Full time

Benefits offered by this job

Remote work

Travel opportunities for training

Job summary

Humana Inc. is seeking a hands-on Utilization Management Clinical Pharmacist 2 (VSP/PT) to perform medical necessity reviews and comprehensive medication assessments for pre-authorizations.

You will review medication care plans, identify cost-effective utilization patterns, advise patients and providers, and follow established guidelines while working remotely. Travel to Humana offices may be required for training and collaboration as needed.

Qualifications

• Bachelor's degree or equivalent required; less than 5 years of technical experience.

Responsibilities

• Complete medical necessity and comprehensive medication reviews for prescriptions requiring pre-authorization.
• Review the medication care plan, utilization, and identify unusual usage patterns; advise patients and providers to promote cost-effective utilization and quality outcomes.
• Follow established guidelines and procedures while interpreting and deciding on the appropriate actions, often with minimal direction.

Skills

Pharmacy

Clinical review

Pre-authorization

Utilization management

Education

Bachelor's degree or equivalent

Job description

Humana Inc. is seeking a hands-on Utilization Management Clinical Pharmacist 2 (VSP/PT) to perform medical necessity reviews and comprehensive medication assessments for pre-authorizations.

You will review medication care plans, identify cost-effective utilization patterns, advise patients and providers, and follow established guidelines while working remotely. Travel to Humana offices may be required for training and collaboration as needed.