Remote Utilization Management Pharmacist (PT)

Humana Inc; United States; Hybrid; USD 104,000 - 143,000; Part time

Job summary

Humana, Inc. is seeking a Staff Utilization Management Clinical Pharmacist (VSP/PT) for a remote, part-time role.

The pharmacist will conduct medical necessity reviews and comprehensive medication assessments for pre-authorization, and guide clinical decisions to optimize patient outcomes. The role emphasizes independent decision-making within established guidelines, with occasional travel for training or meetings.

Qualifications

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

Responsibilities

• Complete medical necessity and comprehensive medication reviews for prescriptions requiring pre-authorization.
• Intervene and advise patients and providers to promote cost effective utilization and quality patient outcomes.
• Analyze medication care plan, utilization, and identify unusual usage patterns to support decision making.

Skills

Clinical pharmacist

Medical necessity reviews

Pre-authorization

Analytical thinking

Education

Bachelor's degree or equivalent

Job description

Humana, Inc. is seeking a Staff Utilization Management Clinical Pharmacist (VSP/PT) for a remote, part-time role.

The pharmacist will conduct medical necessity reviews and comprehensive medication assessments for pre-authorization, and guide clinical decisions to optimize patient outcomes. The role emphasizes independent decision-making within established guidelines, with occasional travel for training or meetings.