Staff Utilization Management Clinical Pharmacist (VSP/PT)

Humana Inc; United States; On-site; 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

## Staff Utilization Management Clinical Pharmacist (VSP/PT)Applylocations: Remote Nationwidetime type: Part timeposted on: Posted Todayjob requisition id: R-424639# **Become a part of our caring community**The Utilization Management Clinical Pharmacist 2 (VSP/PT) is a clinical pharmacist who completes medical necessity and comprehensive medication reviews for prescriptions requiring pre-authorization. The Utilization Management Clinical Pharmacist 2 (VSP/PT) work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.The Utilization Management Clinical Pharmacist 2 (VSP/PT) completes a review that includes a full analysis of the medication care plan, investigation of overall utilization, and identification of unusual usage patterns. Intervenes and advises patients and providers to promote cost effective utilization and quality patient outcomes, as needed. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures.# **Use your skills to make an impact****Required Qualifications*** Typically requires Bachelor's degree or equivalent and less than 5 years of technical experience**Preferred Qualifications****Additional Information**Work at Home Requirements: To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.**Scheduled Weekly Hours**1**Pay Range**The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.$104,000 - $143,000 per year**Description of Benefits**Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers benefits for limited term, variable schedule and per diem associates which are designed to support whole-person well-being. Among these benefits, Humana provides paid time off, 401(k) retirement savings plan, employee assistance program, business travel and accident.