Utilization Management Pharmacist — Prior Authorization Specialist

Judi Health, LLC; United States; Remote; USD 120,000 - 150,000; Full time

Job summary

Judi Health, LLC is seeking an Utilization Management Pharmacist in the United States to oversee prior authorization processes and support clinical programs. The role emphasizes expert guidance to members, providers, and pharmacies while ensuring safe and effective medication use.

The position requires an active pharmacist license and a PharmD or Bachelor of Pharmacy, with 6 months to 1 year of UM or prior authorization experience.

Qualifications

• Active, unrestricted pharmacist license.
• Bachelor’s degree or Doctor of Pharmacy.
• Experience with prior authorization or utilization management.
• Strong communication and organizational skills.

Responsibilities

• Make timely, evidence-based decisions on prior authorizations, appeals, and override requests.
• Accurately document clinical decisions and maintain records in accordance with regulatory and accreditation standards.
• Identify and report potential fraud, waste, and abuse, and support training of team members as needed.

Skills

Pharmacy licensure

Prior Authorization

Clinical knowledge

Communication

Organization

Education

PharmD or Bachelor of Pharmacy

Job description

Judi Health, LLC is seeking an Utilization Management Pharmacist in the United States to oversee prior authorization processes and support clinical programs. The role emphasizes expert guidance to members, providers, and pharmacies while ensuring safe and effective medication use.

The position requires an active pharmacist license and a PharmD or Bachelor of Pharmacy, with 6 months to 1 year of UM or prior authorization experience.