Remote Utilization Management Pharmacist – PBM Expert

UNITAS; United States; Remote; USD 125,000 - 130,000; Full time

Job summary

UNITAS in the United States is seeking a Utilization Management Pharmacist to review prior authorizations, support clinical programs, and guide members, providers, and pharmacies. This role blends clinical decision-making with service excellence in a fast-paced, collaborative environment; requires pharmacy degree, license, and 2+ years of practice; remote work option noted as Remote.

The position emphasizes regulatory compliance (URAC/NCQA) and staying current with guidelines; strong

Qualifications

• Requires a PharmD or BS in Pharmacy with active license.
• 2+ years pharmacy practice experience.
• Strong written and verbal communication skills.
• Ability to manage multiple priorities in a fast-paced setting.
• Availability for after-hours, weekends, and holidays on rotating schedule.

Responsibilities

• Review and decide on prior authorization requests per guidelines.
• Ensure compliance with federal and state regulations across plans.
• Document clinical decisions and maintain records per URAC/NCQA.
• Provide expert guidance to members, prescribers, and pharmacies via phone.
• Stay current with prescribing guidelines and internal policies.
• Follow HIPAA and protect patient privacy.
• Identify fraud, waste, and abuse.
• Support training and development of team members.
• Assist leadership with special projects and process improvements.

Skills

Communication

Writing

Organization

Multitasking

Education

PharmD

Job description

UNITAS in the United States is seeking a Utilization Management Pharmacist to review prior authorizations, support clinical programs, and guide members, providers, and pharmacies. This role blends clinical decision-making with service excellence in a fast-paced, collaborative environment; requires pharmacy degree, license, and 2+ years of practice; remote work option noted as Remote.

The position emphasizes regulatory compliance (URAC/NCQA) and staying current with guidelines; strong