Remote Utilization Management Pharmacist (Specialty Meds)

CommunityCare, Inc.; Tulsa (OK); Remote; USD 90.000 - 150.000; Vollzeit

Benefits dieser Stelle

Remote work option

Zusammenfassung

CommunityCare, Inc. is seeking an Utilization Management Clinical Pharmacist to optimize medication use, support formulary development, and ensure compliant, cost-conscious therapy.

This role provides clinical expertise for medical injectable and specialty medications and collaborates with multidisciplinary teams. The ideal candidate holds a PharmD or BS in Pharmacy with an active US license and 5+ years in managed care or PBM settings, and can work remotely.

Qualifikationen

• License to practice pharmacy in any US jurisdiction.
• Experience interpreting clinical literature and guidelines.
• Familiarity with Medicare Part D and Commercial PBM operations.

Aufgaben

• Review prior authorization requests for medical injectable and specialty medications.
• Approve or deny medication requests within turnaround time requirements.
• Collaborate with pharmacy technicians and clinicians to support UM decisions.
• Develop and maintain evidence-based clinical criteria and prior authorization guidelines.
• Provide clinical consultation on complex requests and coverage determinations.
• Develop educational materials and provider communications.
• Participate in provider outreach and academic detailing initiatives.

Kenntnisse

Utilization management

Medicare & PBM knowledge

Clinical decision making

Analytical skills

Regulatory compliance

Communication & presentation

Ausbildung

PharmD or BS in Pharmacy

Active pharmacist license (US)

5+ years clinical pharmacy in managed care/PBM

Tools

Microsoft Office

Pharmacy information systems

Jobbeschreibung

CommunityCare, Inc. is seeking an Utilization Management Clinical Pharmacist to optimize medication use, support formulary development, and ensure compliant, cost-conscious therapy.

This role provides clinical expertise for medical injectable and specialty medications and collaborates with multidisciplinary teams. The ideal candidate holds a PharmD or BS in Pharmacy with an active US license and 5+ years in managed care or PBM settings, and can work remotely.