Remote Utilization Management Pharmacist - Specialty Meds

CommunityCare; Oregon; Hybrid; USD 110,000 - 160,000; Full time

Job summary

CommunityCare is seeking an Utilization Management Clinical Pharmacist to optimize medication use, support favorable outcomes, and ensure regulatory compliance. The role focuses on medical injectable and specialty medication utilization, formulary development, and clinical policy creation.

Responsibilities include reviewing prior authorizations, collaborating with clinicians, and developing evidence-based criteria to guide cost-conscious, effective therapy for members.

Qualifications

• Strong knowledge of managed care pharmacy, utilization management, and formulary management principles.

Responsibilities

• Review prior authorization requests for medical injectable, specialty, and other high-cost medications using evidence-based clinical criteria, regulatory requirements, and benefit design.

Skills

Managed care pharmacy

Utilization management

Formulary management

Microsoft Office

Pharmacy information systems

Communication skills

Remote work

Education

PharmD or BS in Pharmacy

Oklahoma pharmacist license or ability to obtain in 180 days

Tools

Pharmacy information systems

Job description

CommunityCare is seeking an Utilization Management Clinical Pharmacist to optimize medication use, support favorable outcomes, and ensure regulatory compliance. The role focuses on medical injectable and specialty medication utilization, formulary development, and clinical policy creation.

Responsibilities include reviewing prior authorizations, collaborating with clinicians, and developing evidence-based criteria to guide cost-conscious, effective therapy for members.