Remote Utilization Management Pharmacist | Reviewer

Humana Inc; Lansing (MI); On-site; USD 104,000 - 143,000; Full time

Benefits offered by this job

Remote work

Job summary

The Utilization Management Clinical Pharmacist 2 (VSP/PT) at Humana Inc. is a remote role focused on medical necessity reviews and comprehensive medication reviews for pre-authorization prescriptions.

You will interpret utilization data, determine appropriate actions, and support cost-effective, high-quality patient care. Responsibilities include reviewing medication care plans, identifying unusual usage patterns, and communicating recommendations to patients and providers.

Qualifications

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

Responsibilities

• Complete medical necessity reviews and comprehensive medication reviews for pre-authorization prescriptions.
• Analyze medication care plans and utilization to promote cost-effective, quality outcomes.
• Intervene and advise patients and providers as needed.

Education

Bachelor's degree or equivalent

Job description

The Utilization Management Clinical Pharmacist 2 (VSP/PT) at Humana Inc. is a remote role focused on medical necessity reviews and comprehensive medication reviews for pre-authorization prescriptions.

You will interpret utilization data, determine appropriate actions, and support cost-effective, high-quality patient care. Responsibilities include reviewing medication care plans, identifying unusual usage patterns, and communicating recommendations to patients and providers.